OBJECTIVE: To study the contribution of hormonal cytology in contemporary disturbances of fertility. DESIGN: Over a 10-year period (2006-2015), 6,688 vaginal fornix cytologies of 2,350 patients were investigated. For a more detailed analysis, a 3-year period from 2013 to 2015 was chosen. Four hundred and fifty-two patients were investigated, many of them several times and for a period longer than the 3 years analyzed. RESULTS: The main disorders examined and treated via a gentle hormonal medication support and life style corrections by a pediatric gynecologist were: pubertas praecox - thelarche praecox and early menarche; dysfunctional juvenile metrorrhagia; central and peripheral endocrine disorders; eating disorders - anorexia mentalis and bulimia; obesity; excessive sport activities; autoimmune disorders, and others. Normalization of the menstrual cycle was achieved while monitoring progress with a series of hormonal cytologies in a majority of patients. CONCLUSIONS: Hormonal cytology is a non-invasive and economical method, illustrating the direct effect of steroid on target cells. It contributes to reproductive health support by: (a) indicating the possible need and type of steroid therapy; (b) monitoring the normalization of cycle disturbances; (c) ruling out or indicating the need for more detailed steroid metabolism investigation. Thus, it represents a basic but valuable means of examination in child and adolescent gynecology.

• MeSH
• časové faktory MeSH
• cytodiagnostika metody   MeSH
• dítě MeSH
• dospělí MeSH
• estrogeny aplikace a dávkování   MeSH
• fertilita MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• menstruační cyklus * účinky léků   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Papanicolaouův test MeSH
• prediktivní hodnota testů MeSH
• předškolní dítě MeSH
• progestiny aplikace a dávkování   MeSH
• reprodukční zdraví * MeSH
• reprodukovatelnost výsledků MeSH
• vagina účinky léků   patologie   patofyziologie   MeSH
• vaginální stěr MeSH
• věkové faktory MeSH
• výsledek terapie MeSH
• ženská infertilita diagnóza   farmakoterapie   etiologie   patologie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

In 2008, the organized Czech National Cervical Cancer Screening Programme (CNCCSP) was initiated by transformation of the existing opportunistic efforts. The aim of our study was to examine recent cervical cancer burden trends and to assess the quality of the Czech National Cervical Cancer Screening Programme using a set of standard performance indicators. Our study utilized data from the national Cervical Cancer Screening Registry and the Czech National Cancer Registry. We computed internationally accepted indicators and assessed time trends and variability among screening centres. Between 1995 and 2011, the incidence of age-standardized cervical cancer decreased by 21% (1023 cases in 2011), and the mortality decreased by 35% (399 deaths in 2011). The annual coverage of the target population by cervical screening increased to 56% in 2013 (as compared with 35% in 2001). If we consider a 2-year interval (2012-2013), the estimated coverage was 77%. Over two million women underwent screening in 2013; 96% of them had a negative result. About 0.2% of smears showed cytological signs of a high-grade intraepithelial lesion or a malignancy, and the estimated positive predictive value for advanced intraepithelial neoplasia (cervical intraepithelial neoplasia grade 2+) was 79.6%. However, performance indicators show considerable heterogeneity between screening centres. The reported values of performance indicators are in line with the results of programmes that have previously been shown to be successful in terms of decreasing the cervical cancer burden, and are promising with respect to an even more pronounced decrease in cervical cancer mortality in the near future, provided that continuous quality improvement can be maintained. Linkage studies between screening, cancer and cause-of-death registers can provide further information on screening effectiveness and validity issues.

• MeSH
• časná detekce nádoru metody   trendy   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory děložního čípku diagnóza   epidemiologie   MeSH
• registrace * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Úvod: Národní program screeningu karcinomu děložního hrdla v ČR byl zahájen v roce 2009. Cílem tohoto sdělení je popsat jeho výsledky v prvních letech po jeho transformaci v plnohodnotný organizovaný program. Materiál a metody: V průběhu prvních let byla stabilizována síť 37 akreditovaných laboratoří zajišťujících snadnou dostupnost vyšetření na celém území ČR. Cílovou skupinou, na kterou v současnosti cílí adresné zvaní, je sice populace žen 25–70 let, preventivní screeningové vyšetření je však hrazeno jedenkrát ročně i ženám mimo tento věkový interval. Program je vybaven informační podporou Institutu bio­statistiky a analýz Masarykovy univerzity, který provozuje Registr screeningu karcinomu hrdla děložního. Výsledky: Incidence a mortalita rakoviny hrdla děložního v ČR v průběhu poslední dekády znatelně klesá. Do konce roku 2013 bylo z akreditovaných laboratoří hlášeno do registru více než 11 mil. vyšetření a zachyceno více než 15 000 závažných lézí hrdla děložního. Analýzou dat registru je monitorována kvalita jednotlivých laboratoří i efektivita programu jako celku. Závěr: Slibný start programu je zásadním argumentem pro jeho další pokračování. Má potenciál snížit incidenci zhoubných nádorů hrdla děložního v ČR na hodnoty srovnatelné se zeměmi s vyspělými zdravotnickými systémy.

Introduction: The nationwide Cervical Cancer Screening Programme in the Czech Republic was introduced in 2009. The aim of this article is to describe the results of this programme in the first few years after its transformation into a fully-fledged, organised programme. Material and Methods: During the first few years, a network of 37 accredited laboratories was stabilised, ensuring that examinations would be readily available across the Czech Republic. Although all women aged between 25 and 70 years fall within the target group of the current personalised invitation programme, women not in this age group are reimbursed for preventive screening examinations as well. The programme is equipped with an information support provided by the Institute of Biostatistics and Analyses of the Masaryk University, which runs the Cervical Cancer Screening Registry. Results: Cervical cancer incidence and mortality rates in the Czech Republic have seen a significant decrease over the last decade. By the end of 2013, more than 11 million examinations were reported to the registry by the accredited laboratories, and more than 15,000 serious cervical lesions were detected. Analysis of the data from the registry makes it possible to monitor the quality of individual laboratories and the effectiveness of the entire programme. Conclusion: The promising start of the programme provides a strong argument for its continuation. The program­­me has the potential to decrease cervical cancer incidence rates in the Czech Republic to values comparable with those reported by countries with advanced health care systems. Key words: cervical cancer – population‑based screening – cytology – health care quality indicators This study was supported by the project 36/14//NAP “Development and implementation of meth­odology for the evaluation of effectiveness of personalised invitations of citizens to cancer screening programmes” as part of the program­­me of the Czech Ministry of Health “National action plans and conceptions”. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers. Submitted: 25. 9. 2014 Accepted: 21. 10. 2014

• Klíčová slova
• Národní onkologický registr,
• MeSH
• časná detekce nádoru MeSH
• cytodiagnostika MeSH
• dospělí MeSH
• incidence MeSH
• laboratoře normy   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory děložního čípku * diagnóza   epidemiologie   mortalita   prevence a kontrola   MeSH
• pacientův souhlas se zdravotní péčí statistika a číselné údaje   MeSH
• Papanicolaouův test * statistika a číselné údaje   MeSH
• plošný screening * metody   organizace a řízení   statistika a číselné údaje   MeSH
• řízení kvality MeSH
• senioři MeSH
• ukazatele kvality zdravotní péče MeSH
• vládní programy MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• časná detekce nádoru MeSH
• nádory MeSH
• plošný screening MeSH
• programy národního zdraví MeSH
• zdravotní pojištění MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• onkologie
• NLK Publikační typ
• CD-ROM

Cell-mediated immunity (CMI) response to different antigens was examined in healthy women, in patients with cervical precancerous lesions, and in patients with cervical cancer. Cervical lesions were diagnosed by cytological (PAP) smears, from examination by colposcopy, and from "punch" biopsy material by histology. CMI response is related to specific processes in healthy and cancer cells. CMI was investigated by leukocyte adherence inhibition (LAI) assay using specific antigen (prepared from cervical carcinoma tissue) and non specific antigen (prepared from blood of mice infected by LDH--lactate dehydrogenase--virus). The CMI responses of healthy women and cancer patients to the antigens used are different: the majority of T lymphocytes display adherence and non adherence, respectively (but the CMI responses elicited by the antigens are not equal and small quantitative differences are observed). Regardless of the CIN (cervical intraepithelial neoplasia) grades, CMI responses correspond either to healthy women or to cervical carcinoma patients (at about similar ratio of cases in all the CIN groups). Effect of non specific antigen suggests that cervical carcinoma transformation may be connected with reduction of mitochondrial activity similar to processes in LDH virus infection.

• MeSH
• antigeny nádorové metabolismus   MeSH
• buněčná adheze MeSH
• buněčná imunita MeSH
• L-laktátdehydrogenasa metabolismus   MeSH
• LDH virus metabolismus   MeSH
• leukocyty cytologie   MeSH
• lidé MeSH
• mitochondrie metabolismus   MeSH
• nádory děložního čípku genetika   imunologie   patologie   MeSH
• prekancerózy MeSH
• T-lymfocyty patologie   virologie   MeSH
• vysokoúčinná kapalinová chromatografie MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

A comparison of cervical cancer incidence and mortality in the Czech Republic with that from other countries shows that the burden of cervical cancer here is considerably higher than in Western Europe, where screening is widespread. In May 2008, the International Conference on Human Papillomavirus in Human Pathology was convened to review the latest evidence and to formulate consensus recommendations for the reduction of cervical cancer rates. The Czech Republic is spending considerable resources on cervical cancer prevention, but these resources are being used inefficiently. The current system is characterized by a lack of coordination and monitoring that leads to the over-screening of a minority of women while the majority of the target population are under-screened or not screened at all. It was recommended that a comprehensive, organized programme be implemented, coordinated by an independent administrative body with legal and budgetary responsibility. As the laboratory infrastructure and professional technical skills required for a quality-assured organized screening programme are already in place, implementation of this programme would not require much in the way of additional resources to produce substantial cost-effective reductions in cervical cancer rates.

• MeSH
• Alphapapillomavirus izolace a purifikace   MeSH
• konsensuální konference jako téma MeSH
• lidé MeSH
• nádory děložního čípku epidemiologie   prevence a kontrola   virologie   MeSH
• plošný screening metody   organizace a řízení   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• antigeny MeSH
• buněčná imunita MeSH
• dysplazie děložního hrdla MeSH
• karcinom MeSH
• lidé MeSH
• nádory děložního čípku MeSH
• prekancerózy MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH

The principal aims of this study were to test whether persistence of human papillomavirus (HPV) DNA is predictive of recurrent disease in women after surgical treatment for cervical lesions, to distinguish between persistent and newly acquired HPV infection, and to observe the effect of surgical treatment on levels of HPV-specific antibodies. A group of 198 patients surgically treated for low-grade and high-grade squamous intraepithelial lesions and 35 age-matched controls were monitored for 18 months at 6-month intervals. The presence of HPV DNA in cervical smears was detected by means of consensus polymerase chain reaction, and serum levels of HPV-specific antibodies to HPV types 16, 18, 31, 33, and 45 were measured. In ten patients positive for HPV type 16 in consecutive samples, the HPV 16 variants were identified using a polymerase chain reaction specific for the long control region. Data regarding demographics, risk factors for cervical cancer, and risks related to HPV exposure were collected through a patient questionnaire. Subjects persistently positive for HPV DNA were more likely to present with cytological and/or colposcopical abnormalities. A higher reactivity to HPV-specific antibodies was observed in these women at the 18-month follow-up visit. All ten patients with HPV 16 infection detected in consecutive samples showed persistence of either the same prototype or the same variant during the follow-up period. Risky sexual behavior and smoking were more common in patients than in controls. Persistent HPV infection as demonstrated by both HPV DNA detection and antibody detection appears to be a risk factor for the recurrence of pathological findings in women after surgery. An individually based approach to surgical treatment is an important factor in the outcome of disease at follow-up.

• MeSH
• DNA virů analýza   MeSH
• dospělí MeSH
• financování organizované MeSH
• infekce onkogenními viry MeSH
• infekce papilomavirem epidemiologie   imunologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lidský papilomavirus 16 genetika   imunologie   izolace a purifikace   MeSH
• longitudinální studie MeSH
• mladiství MeSH
• nádory děložního čípku chirurgie   virologie   MeSH
• následné studie MeSH
• nemoci cervix uteri chirurgie   virologie   MeSH
• Papillomaviridae genetika   izolace a purifikace   MeSH
• prevalence MeSH
• protilátky virové MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• senioři MeSH
• ženské pohlaví MeSH

Dlouhodobé sledování (1960–2003) incidence rakoviny cervisu v ČR prověřilo úlohu a vliv PAP-testu, organizaci zdravotní gynekologické služby na výsledky incidence rakoviny cervixu v ČR. Jsou uvedena i doporučení mezinárodní organizace EFCS, IAC v boji s rakovinou cervixu.

Results of trials to reduce incidence of cervical cancer

• MeSH
• cytodiagnostika dějiny   metody   využití   MeSH
• lidé MeSH
• nádory děložního čípku diagnóza   patologie   prevence a kontrola   MeSH
• plošný screening dějiny   využití   MeSH
• ženy MeSH
• Check Tag
• lidé MeSH

• MeSH
• cytodiagnostika MeSH
• diagnostické techniky a postupy ekonomika   využití   MeSH
• gynekologie metody   MeSH
• lidé MeSH
• nádory děložního čípku diagnóza   prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kongresy MeSH