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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Women’s Health Bulletin
- نوع مقاله: Journal Article
- کلمات کلیدی: high,Frozen Sections,Conization,Grade Intraepithelial Neoplasia
- چکیده:
- چکیده انگلیسی: Background: Meticulous examination of frozen section of cone specimens is required to precisely evaluate the resection margin status and rule out invasion in cases with high-grade cervical intraepithelial neoplasia (CIN). Objectives: The aim of the present study was to determine the role of frozen section examination (FSE) of the cone specimen in the evaluation of the resection margin status and to rule out invasion in patients with high-grade CIN. Patients and Methods: This cross-sectional study was performed on 38 patients with high-grade CIN undergoing conization biopsy at Imam Hossein hospital in Tehran from April 2012 through May 2013. Then, FS examination was performed for all patients and the results obtained were compared with those of permanent paraffin sections. Results: Thirty-three (86.8%) out of 38 patients had the same results in frozen and permanent sections of cone biopsy margin specimens (P = 1). Two out of 33 (6.1%) patients had frozen and permanent positive margins and 31 (93.9%) patients had negative frozen and permanent margins. Among the other 5 patients (13.2%), 2 had positive frozen margins and negative permanent margins and 3 patients had negative frozen margins and positive permanent margins. Diagnostic accuracies in cone margin and lesion grading were 63.1% and 44.7%, respectively. Conclusions: In conclusion, in high-grade CIN, FS examination was a rapid, reliable and cost-effective means of evaluating cervical conization specimens.
- انتشار مقاله: 11-10-1348
- نویسندگان: Tahereh Ashraf Ganjooei,Zahra Vahedpoorfard,Mitra Rafiezadeh,Maliheh Arab,Farah Farzaneh,Maryam Sadat Hosseini,Mehdi Yaseri
- مشاهده
- جایگاه : پژوهشی
- مجله: Reviews in Clinical Medicine
- نوع مقاله: Journal Article
- کلمات کلیدی: Neuroendocrine tumor,Neoplasms,vulva
- چکیده:
- چکیده انگلیسی: Vulvar cancer is a rare malignancy representing less than 1% of the cancers, which is diagnosed in women with a high incidence of local recurrence and distant metastasis and carries a poor prognosis. We presented a 51-year-old woman with a lesion in the vulva appeared for three months. The lesion was large, ulcerative, hemorrhagic, tender, and mobile with no lymphadenopathy. Excisional biopsy demonstrated a high-grade malignant neoplasm with lymphovascular invasion. Based on the immunohistochemistry test, the patient was diagnosed with neuroendocrine carcinoma with poorly differentiated tumor. In the diagnostic workup, there were two small lymph nodes on the left inguinal area. The patient was subjected to radical vulvectomy and bilateral illioinguinal lymphadenectomy. In addition, she was prescribed to undergo adjuvant chemotherapy for three cycles. Subsequently, she was given hyperfractionated radiotherapy in the pelvis and bilateral inguinals concurrently with chemotherapy. In the last follow-up visit in 32 months later, the patient was disease-free in the physical examination, and the laboratory tests and imaging findings were normal.
- انتشار مقاله: 01-04-1396
- نویسندگان: Shaghayegh Kamian,Mitra Rafieizadeh,Maliheh Arab,Masume Shafiei
- مشاهده
- جایگاه : پژوهشی
- مجله: Reviews in Clinical Medicine
- نوع مقاله: Journal Article
- کلمات کلیدی: Neuroendocrine tumor,Neoplasms,vulva
- چکیده:
- چکیده انگلیسی: Vulvar cancer is a rare malignancy representing less than 1% of the cancers, which is diagnosed in women with a high incidence of local recurrence and distant metastasis and carries a poor prognosis. We presented a 51-year-old woman with a lesion in the vulva appeared for three months. The lesion was large, ulcerative, hemorrhagic, tender, and mobile with no lymphadenopathy. Excisional biopsy demonstrated a high-grade malignant neoplasm with lymphovascular invasion. Based on the immunohistochemistry test, the patient was diagnosed with neuroendocrine carcinoma with poorly differentiated tumor. In the diagnostic workup, there were two small lymph nodes on the left inguinal area. The patient was subjected to radical vulvectomy and bilateral illioinguinal lymphadenectomy. In addition, she was prescribed to undergo adjuvant chemotherapy for three cycles. Subsequently, she was given hyperfractionated radiotherapy in the pelvis and bilateral inguinals concurrently with chemotherapy. In the last follow-up visit in 32 months later, the patient was disease-free in the physical examination, and the laboratory tests and imaging findings were normal.
- انتشار مقاله: 01-04-1396
- نویسندگان: Shaghayegh Kamian,Mitra Rafieizadeh,Maliheh Arab,Masume Shafiei
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Recurrence,cervical intraepithelial neoplasia,Neutrophils,Lymphocytes,Blood Platelets
- چکیده:
- چکیده انگلیسی: Background: Immune system status is a factor related to cervical intraepithelial neoplasia (CIN) recurrence.
neutrophil-lymphocyte ratio (NLR) is a useful factor in assessing the immune status. The aim of this study was to
evaluate the prognostic value of NLR factor for CIN recurrence in patient who underwent excisional procedure and its
relationship with recurrence free survival (RFS). Methods: In this historical cohort study, a population of 307 patients
with CIN (confirmed by excisional pathology) from 2009 to 2017 were selected. NLR and hematologic factors were
measured before surgery and the follow-up records of these patient were analyzed. The recurrence rate and RFS were
assessed during the follow-up phase. Results: The NLR cut-off point of 1.9 was determined using the Youden Index.
NLRUnivariate analysis showed that higher NLR values (P<0.001), absolute neutrophilic counts (ANC) (P<0.001) and
platelet lymphocytic ratios (PLR) (P=0.002) were significantly associated with reduction in RFS. The results of Cox
regression showed that removing more tissue during excision (HR = 0.325; 95% CI (0.936-0.136) significantly reduced
the hazard of recurrence, higher NLR (HR = 4.55; 95% CI) (1.97-10.51) and white blood cell (WBC) count levels (HR
=1.27; 95% CI, 1.04-1.55), significantly decreased RFS, but PLR and ANC associated with RFS were not confirmed
by Cox regression. Conclusion: NLR and total WBC count might be prognostic factors involved in the prediction of
recurrence and RFS in CIN patient underwent excisional procedure. To confirm these results, more prospective studies
with larger sample sizes are needed.- انتشار مقاله: 08-12-1397
- نویسندگان: Farah Farzaneh,Nafiseh Faghih,Maryam Sadat Hosseini,Maliheh Arab,Tahereh Ashrafganjoei,Atyeh Bahman
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: cervical cancer,Papanicolaou Smear,Anal Neoplasms,Anal Canal Abnormalities,Cervical Intraepithelial Neoplasms
- چکیده:
- چکیده انگلیسی: Background: Anal cancer is uncommon. Although uncommon, the incidence of anal cancer has increased among
the general population of the United States and other countries over the past 30 years. We evaluated anal cytology in
women with the history of abnormal pap smear, cervical intraepithelial neoplasia, cervical cancer and high risk HPV
for anogenital dysplasia. Methods: In this cross-sectional study, 153 patients over the age of 21 years, referred to Imam
Hossein Hospital in 1395-1396 who were being monitored due to abnormal pap smear, cervical cancer, CIN and high
risk HPV, were evaluated with anal cytology for anogenital dysplasia. Results: 153 patients were enrolled in four
main groups. Among those with a history of abnormal pap smear (39 patients), only 25% of the patients with HSIL
had abnormal anal pap smear, and the rest of them had negative anal smear. Among those with a history of CIN (61
patients), patients with CIN III, 30.8% had abnormal anal smear, while the rest had a negative anal smear. Among those
with a high risk of HPV (23 patients), 50% of the patients with concurrent positive HPV 16 and 18 had anal abnormal
smear. Patients with a history of cervical cancer (30 patients) who had radiotherapy with or without surgery showed a
negative anal smear. The ratio of anal SIL positive of individuals with a sexual partner was only 1.9%, while this ratio
was 27.3% for those with more than one partner and this difference was statistically significant (P <0.0001). 15.4%
of smokers had positive anal SIL test result, while, only 2.9% non-smokers had the same result, and this difference
was statistically significant (P = 0.03). 20% of the patients who had anal intercourse showed a positive anal SIL score
result, compared to 1% for those who did not. This difference was statistically significant (P <0.0001). Conclusion:
Among people with a history of abnormal cervical pap smear, CIN, cervical cancer and high-risk HPV during the last
6 months, abnormal anal tests are most commonly seen in patients who had risk factors such as anal sex, cigarette,
multi partner etc. with high grade interepithelial squamous cervix such as HSIL, CIN III, HPV 16 and 18; more studies
in larger sample size are needed to have the better conclusion.- انتشار مقاله: 09-08-1396
- نویسندگان: Maryam Sadat Hosseini,Donya Khosravi,Farah Farzaneh,Abdalali Ebrahimi,Maliheh Arab,Tahereh Ashraf Ganjoie,Farzane Jamdar,Atefeh Moridi,Mohammad Chehrazi
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Optimal Debulking,Neoadjuant Chemotherapy,CA125,Prediction Model
- چکیده:
- چکیده انگلیسی: Background: Primary cytoreduction surgery followed by chemotherapy is the cornerstone treatment for epithelial
ovarian cancer (EOC). In patients with a low probability of optimal primary surgical debulking, neoadjuvant
chemotherapy (NACT) followed by interval debulking increases the chance of optimal surgery. The aim of this study
was to develop a model to identify preoperative predictors for suboptimal cytoreduction. Methods: Medical records
of patients with EOC who underwent primary cytoreductive surgery in a referral tertiary gyneco-oncology center
were reviewed from 2007 to 2017. Data were collected on a range of characteristics including demographic features,
comorbidities, serum tumor markers, hematologic markers, preoperative imaging, surgical procedures, and pathologic
reports. Univariate and multivariate analyses were performed to clarify the ability of preoperative factors to predict
suboptimal primary surgery. Results: The majority of patients (71.3%) who underwent primary cytoreductive surgery
were optimally debulked. Based on the Youden index, the best cut-off point for the serum CA125 level to distinguish
suboptimal debulking was 420U/ml with 0.730 (95%CI:0.559 to 0.862) sensitivity and 0.783 (0.684 to 0.862) specificity.
Multiple logistic regression results showed that serum CA125 level >420 U/ ml (p value <0.001), the presence of liver
metastasis on preoperative imaging (p value: 0.041) and ascites (p value: 0.032) or massive ascites (p value:0.010)
significantly increased the risk of suboptimal debulking (logit p = 2.36 CA125 level +1.85 Liverinvolvement +1.68
presence of Ascites+ 2.28 Massive Ascites). Conclusion:The present study suggests that a serum CA125 level >420 U/ml,
the presence of ascites or massive ascites and liver metastasis are strong predictors of suboptimal primary surgery in
cases of EOC. Based on the constructed model, with any of these 4 factors, the probability of suboptimal debulking in
EOC is more than 80%.- انتشار مقاله: 05-09-1396
- نویسندگان: Maliheh Arab,Farzane Jamdar,Maryam Sadat Hosseini,Robabe Ghodssi-Ghasemabadi,Farah Farzaneh,Tahereh Ashrafganjoie
- مشاهده