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7 results

  • The favourable effects of long-term selenium supplementation on regression of cervical tissues and metabolic profiles of patients with cervical intraepithelial neoplasia: a randomised, double-blind, placebo-controlled trial

  • Maryam Karamali, Sepideh Nourgostar, Ashraf Zamani, Zahra Vahedpoor, Zatollah Asemi
  • Journal:
    British Journal of Nutrition / Volume 114 / Issue 12 / 28 December 2015
    Published online by Cambridge University Press:
    06 October 2015, pp. 2039-2045
    Print publication:
    28 December 2015
    • Article
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  • This study was conducted to assess the effects of long-term Se administration on the regression and metabolic status of patients with cervical intraepithelial neoplasia grade 1 (CIN1). This randomised, double-blind, placebo-controlled trial was carried out among fifty-eight women diagnosed with CIN1. To diagnose CIN1, we used specific diagnostic procedures of biopsy, pathological diagnosis and colposcopy. Patients were randomly assigned to two groups to receive 200 μg Se supplements as Se yeast (n 28) or placebo (n 28) daily for 6 months. After 6 months of taking Se supplements, a greater percentage of women in the Se group had regressed CIN1 (88·0 v. 56·0 %; P=0·01) compared with those in the placebo group. Long-term Se supplementation, compared with the placebo, resulted in significant decreases in fasting plasma glucose levels (−0·37 (sd 0·32) v. +0·07 (sd 0·63) mmol/l; P=0·002), serum insulin levels (−28·8 (sd 31·2) v. +13·2 (sd 40·2) pmol/l; P<0·001), homeostatic model assessment of insulin resistance values (−1·3 (se 1·3) v. +0·5 (se 1·4); P<0·001) and a significant elevation in quantitative insulin sensitivity check index (+0·03 (sd 0·03) v. −0·01 (sd 0·01); P<0·001). In addition, patients who received Se supplements had significantly decreased serum TAG (−0·14 (sd 0·55) v. +0·15 (sd 0·38) mmol/l; P=0·02) and increased HDL-cholesterol levels (+0·13 (sd 0·21) v. −0·01 (sd 0·15) mmol/l; P=0·003). In addition, compared with the placebo group, there were significant rises in plasma total antioxidant capacity (+186·1 (sd 274·6) v. +42·8 (sd 180·4) mmol/l; P=0·02) and GSH levels (+65·0 (sd 359·8) v. −294·2 (sd 581·8) μmol/l; P=0·007) and a significant decrease in malondialdehyde levels (−1·5 (sd 2·1) v. +0·1 (sd 1·4) μmol/l; P=0·001) among those who took Se supplements. Overall, taking Se supplements among patients with CIN1 led to its regression and had beneficial effects on their metabolic profiles.

  • 2 - Basic pathology of gynaecological cancer

  • Edited by Nigel Acheson, David Luesley
  • Book:
    Gynaecological Oncology for the MRCOG and Beyond
    Published online:
    05 August 2014
    Print publication:
    01 January 2011, pp 15-34

  • Summary

    This chapter describes the salient features that would enable the gynaecologist to aid and understand the pathologist in examination of specimens removed for diagnosis and definitive surgery for gynaecological cancers. Cervical intraepithelial neoplasia (CIN) is the term used to describe proliferative intraepithelial squamous lesions that display abnormal maturation and cytonuclear atypia. The diagnosis of endometrial hyperplasia has been shown to be an area of gynaecological pathology with low diagnostic reproducibility. Mixed tumours of the uterus contain a mixture of glands and mesenchymal tissue: müllerian adenomyomas, including adenomyoma of endocervical type, typical adenomyomas of endometrioid type, atypical polypoid adenomyoma. There are three main groups of primary ovarian tumours: epithelial tumours that are derived from müllerian epithelium; sex-cord or stromal tumours, derived from the ovarian stroma, sex-cord derivatives or both; and germ cell tumours, which originate from the ovarian germ cells.

  • 1 - Basic epidemiology

  • Edited by Nigel Acheson, David Luesley
  • Book:
    Gynaecological Oncology for the MRCOG and Beyond
    Published online:
    05 August 2014
    Print publication:
    01 January 2011, pp 1-14

  • Summary

    Information from epidemiological studies helps us to clarify the aetiology of gynaecological cancers. The mortality associated with cervical cancer has fallen over the second half of the last century in the UK. The link between human papillomavirus (HPV) and cervical cancer has been conclusively established. Most women with endometrial cancers develop abnormal vaginal bleeding as an early symptom and their tumours are diagnosed while confined to the uterus. Epidemiological studies have shown that pregnancy, breastfeeding and oral contraceptive use appear to be protective against the development of ovarian cancer. Apart from its rarity, squamous vulval cancer is a condition that largely affects the elderly: 80% of women with this condition are over 55 years of age. It is not surprising, therefore, that medical comorbidity is high in the vulval cancer population, and the link between HPV, cervical intraepithelial neoplasia (CIN) and cervical cancer is well known.

  • 10 - Impact of LLETZ on subsequent pregnancies

  • from SECTION 3 - Gynaecological Cancers and Precancer
  • Edited by Sean Kehoe, Eric Jauniaux, Pierre Martin-Hirsch, Philip Savage
  • Book:
    Cancer and Reproductive Health
    Published online:
    05 October 2014
    Print publication:
    01 November 2008, pp 115-124

  • Summary

    Large loop excision of the transformation zone (LLETZ) was introduced in the late 1980s and has now become the most popular method of treatment for cervical intraepithelial neoplasia (CIN). It is well known that women with CIN have demographic, behavioural, and sexual characteristics that put them at increased risk of pregnancy-related morbidity. Outcomes related to fertility are reported in two studies after LLETZ, one after laser conisation and after laser ablation, and one after cold knife conisation (CKC). The differences in the seriousness of adverse effects noted between CKC and LLETZ might be related to variations in the amount of tissue removed. Clinicians should counsel women appropriately before excisional treatment regarding the increased risk of preterm birth in a future pregnancy. Women requiring treatment with either CKC, laser conisation or a relatively large loop excision should be warned that they may warrant closer antenatal care in a subsequent pregnancy.

  • 9 - Management of cervical intraepithelial neoplasia during pregnancy

  • from SECTION 3 - Gynaecological Cancers and Precancer
  • Edited by Sean Kehoe, Eric Jauniaux, Pierre Martin-Hirsch, Philip Savage
  • Book:
    Cancer and Reproductive Health
    Published online:
    05 October 2014
    Print publication:
    01 November 2008, pp 111-114

  • Summary

    Cervical intraepithelial neoplasia (CIN) has a high incidence in the reproductive age groups. Colposcopy is safe in pregnancy and, as a result of the extension of the squamous-columnar junction (SCJ) to the ectocervix, it is also satisfactory in the majority of the cases. Generally, the rate of CIN progression during pregnancy is known to be small, and no evidence reveals an increase in the risk of invasive cervical cancer in pregnancy. Infants can acquire human papillomavirus (HPV) from their mothers during labour as they descend through an infected genital tract. A caesarean section should not be recommended for a pregnant woman with CIN solely for the purpose of prevention of HPV transmission to the infant. Modifications of the management principles are required mainly because treatment of CIN during pregnancy can cause serious morbidity and should only be reserved for special circumstances.

  • Human cellular immune responses against human papillomaviruses in cervical neoplasia

  • Stephen Man
  • Journal:
    Expert Reviews in Molecular Medicine / Volume 1 / Issue 5 / 3 July 1998
    Published online by Cambridge University Press:
    21 February 2005, pp. 1-19

  • Human papillomaviruses (HPVs) are ubiquitous DNA viruses that infect cutaneous and mucosal epithelia. A subset of HPVs infects the female genital tract, to induce cervical lesions that can progress to malignancy in some women. DNA from HPVs can be found in >94% of cervical carcinomas (CaCx) worldwide; this strong association suggests that it might be possible to develop either prophylaxis or therapies for cervical neoplasia, based on the manipulation of human immune responses against HPVs. This review examines the current research into human immune responses against HPVs in CaCx and the potential impact of this research on human health.

  • 17 - Cervical cancer: prevention, screening, and early detection

  • from Part IV - Cancer prevention
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University
  • Book:
    Women's Health in Mid-Life
    Published online:
    21 August 2009
    Print publication:
    25 March 2004, pp 287-292

  • Summary

    The incidence of cervical cancer has decreased since the 1950s and stabilized in the 1980s in the USA. The rate of cervical cancer varies widely with race. The purpose of the Pap test is to detect and treat cervical intraepithelial neoplasia (CIN) and, thus, prevent invasive cancer. Case-control studies in the UK have found that cervical cancer screening by Pap test has changed the incidence of cervical cancer over the past 20 years. The frequency, initiation, and cessation of regular Pap tests are controversial. The risk factors linked with cervical cancer include infection with certain subtypes of human papilloma virus (HPV), multiple sexual partners, sexually transmitted diseases, low socioeconomic status, and smoking. Most cases of squamous cervical cancers are caused by HPV. Although the incidence decreases with age, women aged 40-65 years still need cervical cancer screening, but perhaps less often than at younger ages.