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Objective(s): The aim of this study was to assess the prognostic value of pretreatment Positron emission tomography / computed tomography using 18Ffluorodeoxyglucose (FDG-PET/CT) in cervical cancer according to two major histologic types. Methods: Eighty-three squamous cell carcinoma (SCC) patients and 35 adenocarcinoma (AC) patients who underwent pretreatment FDG-PET/CT were retrospectively analyzed. Maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor were calculated. Kaplan-Meier analyses were used to compare correlations between each PET parameter and overall survival (OS). The prognostic values of imaging and clinical parameters were assessed using uni- and multivariable Cox proportional hazard models. Results: SUVmax, SUVmean, and TLG were significantly higher in SCC than in AC (p<0.01 each). No significant difference in MTV was seen between the two groups (p=0.10). As for Kaplan-Meier analyses, in SCC, patients with SUVmax, SUVmean, MTV, and TLG exceeding cutoff values tended to show worse OS than patients with lower values (p=0.07, p=0.27, p<0.01, and p=0.01, respectively, for OS). On the other hand, in AC, patients with MTV and TLG exceeding cutoff values showed significantly worse PFS and OS (p<0.01 each for OS), while SUVmax and SUVmean were unrelated to OS (p=0.91 and p=0.83, respectively for OS). As for multivariable analyses, in SCC, TLG was identified as an independent prognostic factor for OS (p=0.01). In AC, MTV was identified as an independent prognostic factor for OS (p=0.02). Conclusion: Our preliminary data suggest that FDG-PET/CT would be useful for predicting prognosis in cervical cancer, although the clinical significance of quantitative values may differ according to histopathological type. [ABSTRACT FROM AUTHOR]

Background: In recent years, before radical hysterectomy, neoadjuvant chemotherapy (NACT) has been administered to patients with locally advanced cervical cancer to shrink large tumors. It has been reported that this treatment significantly reduces the need for radiotherapy after surgery. The current study aimed to assess the outcome (survival, recurrence, and the need for adjuvant radiotherapy) of locally advanced cervical cancer in patients treated with NACT followed by radical hysterectomy and primary surgery. Methods: In a retrospective cohort study, the records of 258 patients with cervical cancer (stage IB2, IIA, or IIB), who referred to Imam Khomeini Hospital (Tehran, Iran) from 2007 to 2017 were evaluated. The patients were assigned into two groups; group A (n=58) included patients, who underwent radical hysterectomy and group B (n=44) included those, who underwent a radical hysterectomy after NACT. The outcome measures were the recurrence rate, five-year survival rate, and the need for adjuvant radiotherapy. Results: The median for overall survival time in group A and B was 113.65 and 112.88 months, respectively (P=0.970). There was no recurrence among patients with stage IB2 cervical cancer in group B, while the recurrence rate in group A was 19.5% with a median recurrence time of 59.13 months. Lymph node involvement was the only factor that affected patients' survival. The need for postoperative adjuvant radiotherapy in group B was lower than in group A (P=0.002). Conclusion: NACT before the hysterectomy was found to reduce the need for postoperative radiotherapy in patients with locally advanced cervical cancer according to disease stages. As a direct result, adverse side effects and the recurrence rate were reduced, and the overall survival rate of patients with stage IIB cervical cancer was increased. [ABSTRACT FROM AUTHOR]

Background and Objectives: Reassuring women to take part in screening program for cervical cancer cause early diagnosis and declining complication of this cancer. The aim of this study is determining knowledge and attitude of health providers, worked in healthcare centers of Mianeh, a city in north west of Iran. Material and Methods: This descriptive-analytic study included 117 health providers providing primary health services in the Mianeh healthcare facility centers. Data collected by using a 27-items questionnaire that its validity and reliability had been confirmed. Data analysis performed by an Independent Samples t Test in SPSS Results: This study included a total of 187 health providers. Among them, 117 health providers completed the questionnaire (response rates 63 percent). The majority of participants were women (75 percent). The mean knowledge and attitude scores were 10.06 ± 2.31 (the range from zero to 14) and 8.03 ± 3.17(the range from zero to 13), respectively. More than half of participated women, who all were married, had done twice or more screening test for cervical cancer (55.67 percent). There was no statistically significant difference in knowledge and attitude of health providers' score with respect to age, gender, education, marital status and work experience. The knowledge and attitudes score of the female health providers who had done twice or more screening test for cervical cancer were statistically significant higher than others (p value > 0.05). The negative attitude considering cervical screening was caused by experiencing pain (67 percent), ulcer and hemorrhage (53 percent). Conclusion: Though health workers have partially suitable knowledge, attitude and practice toward cervical screening test, appropriate interventions are required to improve them. [ABSTRACT FROM AUTHOR]

Purpose: Improved therapeutic options for cervical cancer are needed. The purpose of this study was to evaluate the synergetic, inhibitory effects of ultrasound-mediated paclitaxel (PTX)- and miR-34a-loaded microbubbles (MBs) on cervical cancer. Methods: U14 cervical cancer cells and xenograft mouse tumors were treated with PTX-miR-34a-MBs. Results: Levels of miR-34a increased in vitro and vivo after treatment with ultrasound-mediated PTX-miR-34a-MBs. Furthermore, this treatment decreased the proliferation of cervical cancer cells, microvessel density, and the expression of Bcl-2 and CDK6, both in vitro and in vivo. Furthermore, Bax expression was increased in the in vivo model. And, tumor volume and weight were significantly reduced by 78.57% and 87.97%, respectively (P < 0.01). Conclusions: These results indicate that ultrasound-mediated PTX-miR-34a-MBs synergistically inhibit the growth of cervical cancer via the upregulation of miR-34a and downregulation of Bcl-2 and CDK6. Thus, PTX-miR-34a-MBs in combination with ultrasound microbubbles are a promising anticancer delivery strategy for treating cervical cancer. [ABSTRACT FROM AUTHOR]

Abstract Objective Expectant follow-up for biopsy-proven cervical intraepithelial neoplasia (CIN) 1 is the current recommendation for the management of this lesion. Nevertheless, the performance of the biopsy guided by colposcopy might not be optimal. Therefore, this study aimed to calculate the rate of underdiagnoses of more severe lesions in women with CIN 1 diagnosis and to evaluate whether age, lesion extent and biopsy site are factors associated with diagnostic failure. Methods Eighty women with a diagnosis of CIN 1 obtained by colposcopy-guided biopsy were selected for this study. These women were herein submitted to large loop excision of the transformation zone (LLETZ). The prevalence of lesions more severe than CIN 1 was calculated, and the histological diagnoses of the LLETZ specimens were grouped into two categories: "CIN 1 or less" and "CIN 2 or worse." Results The prevalence of lesions diagnosed as CIN 2 or worse in the LLETZ specimens was of 19% (15/80). Three women revealed CIN 3, and 1 woman revealed a sclerosing adenocarcinoma stage I-a, a rare type of malignant neoplasia of low proliferation, which was not detected by either colposcopy or previous biopsy. The underdiagnosis of CIN 2 was not associated with the women's age, lesion extension and biopsy site. Conclusions The standard methods used for the diagnosis of CIN 1 may underestimate the severity of the true lesion and, therefore, women undergoing expectant management must have an adequate follow-up.

Background: Cervical cancer is the fourth most common cancer worldwide among women. Objective: To evaluate the implementation and efficiency of the Ecological Papanicolaou staining (Eco- Pap) in exfoliative cytology for the diagnosis of cervical cancer. Methods: A prospective, experimental, cross-sectional research was performed at the Hospital Nacional Docente Madre-Niño "San Bartolomé" during 2015. Three strategies for controlling toxic reagents were used: the use of progressive Harris haematoxylin, polychromatic cytoplasmic solution and direct mounting. Cellular details were analyzed by using the Quality Index Staining, the Bethesda system and the Quality Program for External Evaluation of Cytology. Results: We evaluated 72 901 cervical smears stained with Eco-Pap. The validation of Eco-Pap against the standard Papanicolaou staining had very good agreement (kappa = 0.89), showing a sensitivity and specificity of 88.3 and 98.7%, respectively (p < 0.05). The Eco-Pap had a high diagnostic yield and reduced environmental pollution caused by xylene (72 liters), hydrochloric acid and ammonia (each one with six liters), as well as mercury oxide. Conclusions: The Eco-Pap is a new, efficient and innovative method which eliminates the use of toxiccarcinogenic reagents, generating ecological performance in the diagnosis of cervical cancer. [ABSTRACT FROM AUTHOR]

OBJETIVO: Analisar a prevalência de infecção pelo vírus do papiloma humano (HPV) em mulheres no Brasil. MÉTODOS: Revisão sistemática que incluiu artigos recuperados em busca livre nos portais PubMed e Biblioteca Virtual em Saúde, em abril/2009, utilizando-se os termos "human papillomavirus", "HPV", "prevalence" e "Brazil". Dos 155 artigos identificados, 82 permaneceram após leitura de título e resumo e foram submetidos à leitura integral, sendo selecionados 14 artigos. RESULTADOS: Os artigos sobre o tema foram publicados entre 1989 e 2008. Os 14 artigos representaram estudos de quatro regiões brasileiras (Sudeste 43%, Sul 21,4%, Nordeste 21,4% e Norte 7,1%). Nove artigos relatavam estudos transversais. Em oito utilizaram-se técnicas moleculares para tipagem do HPV e em sete deles utilizou-se captura híbrida para detecção do HPV. As populações estudadas variaram de 49 a 2.329 mulheres. A prevalência geral de infecção do colo do útero pelo HPV variou entre 13,7% e 54,3%, e para as mulheres com citologia normal, variou entre 10,4% e 24,5%. Quatro estudos relataram os tipos de HPV mais freqüentes, segundo resultado de citologia. CONCLUSÕES: As técnicas de citologia disponíveis resultam em diversas classificações e estimativas de prevalência do HPV. Contudo, considerando separadamente os estudos segundo a técnica utilizada, observa-se que a prevalência do HPV tem aumentado. O HPV16 foi o tipo mais freqüente entre as mulheres, independentemente do resultado de citologia. A concentração dos estudos na região Sudeste do País, especialmente nas regiões metropolitanas, mostra que investigações adicionais serão necessárias para aumentar a abrangência das informações disponíveis sobre as mulheres brasileiras.OBJETIVO: Analizar la prevalencia de infección por el virus de papiloma humano en mujeres en Brasil. MÉTODOS: Revisión sistemática que incluyó artículos recuperados en búsqueda libre en las páginas de datos PubMed y Biblioteca Virtual en Salud, en abril/2009, utilizándose los términos "human papillomavirus", "HPV", "prevalence" y "Brazil". De los 155 artículos identificados 82 se mantuvieron luego de leer el título y el resumen y fueron leídos de forma íntegra, siendo seleccionados 14 artículos. RESULTADOS: Los artículos sobre el tema fueron publicados entre 1989 y 2008. Los 14 artículos representaron estudios de cuatro regiones brasileras (Sureste - 43%, Sur - 21,4%, Noreste - 21,4% y Norte - 7,1%). Nueve artículos relatan estudios transversales. En ocho se utilizaron técnicas moleculares para tipaje del HPV e siete de ellos se utilizó captura híbrida para detección del HPV. Las poblaciones estudiadas variaron de 49 a 2.329 mujeres. La prevalencia general de infección de cuello de útero por el HPV varió entre 13,7% y 54,3%, y para las mujeres con citología normal, varió entre 10,4% y 24,5%. Cuatro estudios relataron los tipos de HPV más frecuentes, según resultado de citología. CONCLUSIONES: Las técnicas de citología disponibles resultan en diversas clasificaciones y estimaciones de prevalencia del HPV. Sin embargo, considerando separadamente los estudios según la técnica utilizada, se observa que la prevalencia del HPV ha aumentado. El HPV16 fue el tipo más frecuente entre las mujeres, independientemente del resultado de citología. La concentración de los estudios en la región Sureste del Brasil, especialmente en las regiones metropolitanas, muestra que las investigaciones adicionales serán necesarias para aumentar la amplitud de las informaciones disponibles sobre las mujeres brasileñas.OBJECTIVE: To assess the prevalence of human papillomavirus (HPV) infection in women in Brazil. METHODS: A systematic literature review was conducted with an active search in PubMed and Virtual Health Library databases using the terms "human papillomavirus," "HPV," "prevalence," and "Brazil". Of 155 articles retrieved, 82 were selected after reading their title and abstract. After a thorough examination, 14 articles were included in the study. RESULTS: The 14 articles selected were published between 1989 and 2008 and comprised studies from four Brazilian macroregions (Southeast 43%; South 21.4%; Northeast 21.4%; and North 7.1%). Nine were cross-sectional studies. Eight articles used polymerase chain reaction and seven used hybrid capture for HPV detection. The study samples ranged from 49 to 2,329 women. The overall prevalence of HPV cervical infection was between 13.7% and 54.3%; and women with cytologically normal results had 10% to 24.5% prevalence of HPV cervical infection. Four articles described the most common HPV types. CONCLUSIONS: The cytology techniques available use different classifications leading to different HPV prevalence estimates. However, considering the studies individually according to the detection technique used, the HPV prevalence has increased. HPV16 was the most prevalent type among women, regardless of the cytology result. The concentration of studies in the Southeast region, especially in metropolitan regions, evidences that further investigations are needed to improve information coverage of Brazilian women.

Objectives: The aim of this study was to assess the prognostic value of pretreatment Positron emission tomography / computed tomography using 18 F-fluorodeoxyglucose (FDG-PET/CT) in cervical cancer according to two major histologic types., Methods: Eighty-three squamous cell carcinoma (SCC) patients and 35 adenocarcinoma (AC) patients who underwent pretreatment FDG-PET/CT were retrospectively analyzed. Maximum standardized uptake value (SUV max ), mean standardized uptake value (SUV mean ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor were calculated. Kaplan-Meier analyses were used to compare correlations between each PET parameter and overall survival (OS). The prognostic values of imaging and clinical parameters were assessed using uni- and multivariable Cox proportional hazard models., Results: SUV max , SUV mean , and TLG were significantly higher in SCC than in AC (p<0.01 each). No significant difference in MTV was seen between the two groups (p=0.10). As for Kaplan-Meier analyses, in SCC, patients with SUV max , SUV mean , MTV, and TLG exceeding cutoff values tended to show worse OS than patients with lower values (p=0.07, p=0.27, p<0.01, and p=0.01, respectively, for OS). On the other hand, in AC, patients with MTV and TLG exceeding cutoff values showed significantly worse PFS and OS (p<0.01 each for OS), while SUV max and SUV mean were unrelated to OS (p=0.91 and p=0.83, respectively for OS). As for multivariable analyses, in SCC, TLG was identified as an independent prognostic factor for OS (p=0.01). In AC, MTV was identified as an independent prognostic factor for OS (p=0.02)., Conclusion: Our preliminary data suggest that FDG-PET/CT would be useful for predicting prognosis in cervical cancer, although the clinical significance of quantitative values may differ according to histopathological type., Competing Interests: This research did not receive any specific from funding agencies in the public, commercial, or not-for-profit sectors.

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Introduction: Human papillomavirus (HPV) infection is strongly associated with risk of cervical cancer and genital warts., Aim: The study aimed to report the prevalence of genus alpha human papillomavirus (HPV) types in women with cervical infection and/or inflammatory in Western Iran., Materials and Methods: In a cross-sectional study, 435 women were clinically diagnosed with cervical infections. The method of HPVs detection was polymerase chain reaction (PCR). The majority of patients (304 patients) did Pap smear based on liquid-based specimens., Results: Out of 435 patients, 150 patients (34.5%) had HPV positivity that the prevalence of high-risk HPVs was 52.7%. Out of 76 patients with Pap smear positivity, 68.4% had atypical squamous cells of undetermined significance cytology class and 31.6% had low-grade squamous intraepithelial lesion cytology class. The most prevalence rate of HPV was in age ≤30 years. HPV 16 and HPV 56 were the most prevalence rate among high-risk HPVs. Overall HPV alpha-10 (59%) and HPV alpha-9 (32.2%) had the most prevalence rate., Conclusions: Among high-risk HPVs, HPV 16 was the most common HPV detected in our population with a very low prevalence of HPV 18. In addition, HPV 6 and then HPV 11 had the most prevalence rate in the women with uterine cervix (cervical) infection among low-risk HPVs.