Preinvasive lesion of the uterine cervix can give rise to cervical cancer. High-risk human papillomaviruses with high oncogenic potential are considered to be the main etiopathological factors with interaction of other risk factors (recurrent inflammation of the cervix, injury of the cervix, immunosuppressive conditions, sexual promiscuity, etc.). Early dia-gnosis of these changes at regular gynecological examinations and adequate treatment can prevent of malignant transformation. Organized cervical screening and implementation of nationwide vaccination against human papillomavirus promises to reduce the incidence of cervical cancer.
- Klíčová slova
- preinvasive lesions - uterine cervix - cervical intraepithelial neoplasia - human papillomavirus - vaccination,
- MeSH
- dysplazie děložního hrdla diagnóza patologie terapie MeSH
- infekce papilomavirem diagnóza patologie terapie MeSH
- lidé MeSH
- nádorová transformace buněk MeSH
- nádory děložního čípku diagnóza patologie terapie MeSH
- plošný screening MeSH
- prekancerózy MeSH
- rizikové faktory MeSH
- vakcíny proti papilomavirům aplikace a dávkování MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- vakcíny proti papilomavirům MeSH
Standardized gynecological oncological therapeutical guidelines are based on ordinary predictive factors, such as depth of stromal invasion, histopathological type of tumor, lymphovascular space invasion, lymph node metastases. Unfortunately, the power of these prognostic factors is not able to determine the safety of this procedure in the relation to disease recurrence in a group of patients who are indicated for conservative operations. This is the appropriate area for new, especially biomolecular prognostic factors (proteins: p63, TAp63, p16, p21, p27, COX-2, genes: hTERC, MYCC). Moreover, comprehensive evaluation of cervical cancer prognostic factors and assessment of new biomarkers of cancer can ease prediction of risk of spread outside primary localization and determine probability of disease recurrence. This information can help to individualize surgical, radiotherapeutic and chemotherapeutic treatment.
- MeSH
- lidé MeSH
- nádorové biomarkery analýza MeSH
- nádory děložního čípku diagnóza patologie MeSH
- prognóza MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Názvy látek
- nádorové biomarkery MeSH
In comparison to malignant tumors of vulva, vagina, cervix and uterine corpus, clear morphologic and molecular genetic features of precursor lesions of ovarian carcinoma have not been defined yet. We can see an effort to describe preinvasive lesions to allow dia-gnostics and treatment prior to development of invasive ovarian cancer. This tendency is magnified by the fact that ovarian carcinomas have the highest mortality from all gynecological malignancies. Currently, reports confirming different morphology, pathogenesis and molecular alterations in heterogeneous group of ovarian carcinomas have been described. There is a tendency to divide epithelial malignant tumors into two groups. Low grade ovarian serous carcinoma, low grade endometrioid, clear cell, mucinous ovarian cancers and Brenner tumors of ovary are categorized as type I ovarian tumors. Highgrade serous carcinoma, undifferentiated carcinomas and malignant mixed mesodermal tumors of the ovary (MMMTs) belong to type II tumors. A potential precursor lesion of highgrade serous ovarian cancer has been defined - serous tubal intraepithelial carcinoma.
- Klíčová slova
- preinvasive lesion - ovarian cancer - serous tubal intraepithelial carcinoma (STIC),
- MeSH
- karcinom diagnóza patologie terapie MeSH
- lidé MeSH
- nádory vaječníků diagnóza patologie terapie MeSH
- prekancerózy diagnóza patologie terapie MeSH
- stupeň nádoru MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
Preinvasive lesions of the endometrium are histopathological and molecular alterations related to high-risk of uterine carcinoma development. Incidence has increasing tendency. Atypical endometrial hyperplasia is the preinvasive lesion of type I endometrial carcinoma, developing under a hyperestrogenic background. Carcinoma in situ of the endometrium is considered to be precursor lesion of type II endometrial carcinoma, first of all uterine serous carcinoma. Hysterectomy and bilateral oophorectomy is the main therapeutical modality in both preinvasive lesions of the endometrium. The hormonal therapy with progestogens is the possibility of fertility sparing approach in treatment of histological findings of atypical endometrial hyperplasia in young women. Even though preinvasive lesions of the endometrium are clearly defined, the possibilities of endometrial cancer screening are markedly limited.
- Klíčová slova
- preinvasive lesion - endometrium - atypic endometrial hyperplasia - carcinoma in situ of the endometrium,
- MeSH
- hyperplazie endometria diagnóza patologie terapie MeSH
- karcinom in situ diagnóza patologie terapie MeSH
- lidé MeSH
- nádory endometria diagnóza patologie terapie MeSH
- prekancerózy MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
Preinvasive lesions of the vagina are relatively rare, clearly defined afflictions, originating most of all in association with the highrisk human papillomavirus infection (HR HPV). The most frequent appearance is in coincidence with preinvasive lesions of uterine cervix and in vaginal cuff after hysterectomy. Preinvasive vaginal lesions are divided into squamous lesions (vaginal intraepithelial neoplasia) and nonsquamous lesions. Vaginal adenosis belongs to nonsquamous vaginal preinvasive lesions and is a precursor lesion of vaginal clear cell carcinoma. Surgical and nonsurgical techniques including laser destructive methods and local administration of 5- fluorouracile are used in the treatment of preinvasive lesions of vagina.
- Klíčová slova
- preinvasive lesion - vagina - vaginal intraepithelial neoplasia - vaginal adenosis,
- MeSH
- infekce papilomavirem diagnóza patologie terapie MeSH
- lidé MeSH
- nádory děložního čípku diagnóza patologie terapie MeSH
- nádory vaginy diagnóza patologie terapie MeSH
- prekancerózy MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
For preinvasive lesions of vulva, a common term VIN - vulval intraepithelial neoplasia is used. VIN is a histological dia-gnosis based on abnormal squamous epithelial proliferation. There are two types of VIN apart from their association with human papillomavirus (HPV). Undifferentiated (usual) vulval intraepithelial neoplasia is commonly associated with carcinogenic genotypes of HVP, whereas differentiated vulval intraepithelial neoplasia is not associated with high-risk genotypes of HPV. The article presents an overview of VIN occurence and epidemiology, its classification system and dia-gnostics. In conclusion, VIN therapeutical possibilities are presented. It can be treated with surgical therapy (local excision, partial vulvectomy, vulvectomy, laser vaporization) or medical therapy (imiquimod).
- Klíčová slova
- vulval intraepithelial neoplasia - VIN - epidemiology - therapy,
- MeSH
- infekce papilomavirem klasifikace diagnóza epidemiologie terapie MeSH
- karcinom in situ klasifikace diagnóza epidemiologie terapie MeSH
- lidé MeSH
- nádory vulvy klasifikace diagnóza epidemiologie terapie MeSH
- prekancerózy MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
BACKGROUNDS: Endometrial carcinoma is the most frequent gynecologic malignancy. The incidence is 30 : 100,000 with an increasing tendency. The main therapeutic modality remains radical surgery. The purpose of the study is to evaluate the feasibility of sentinel lymph node (SLN) detection in endometrial cancer using hysteroscopic administration of radiocolloid and the combination of preoperative lymphoscintigraphy with intraoperative gamma-detection probe examination. PATIENTS AND METHODS: From May 2006 to January 2009, 99mTc-labelled nanocolloid (100 MBq) was administered preoperatively in 21 patients with endometrial cancer. On the day of surgery, radiocolloid together with blue dye was injected via 20-gauge needle under the endometrium using hysteroscopy. Lymphoscintigraphy was performed in all patients after 60 minutes. Therapeutic surgery followed the tracer administration 2 hours later in extensity of abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal wash, pelvic lymphadenectomy and in patients with positive high-risk prognostic factors of paraaortic lymphadenectomy. SLN was located by use of gamma-detecting probe intraoperatively. RESULTS: At least one SLN was detected in 17 of 21 (81%) patients included in the study. The mean number of detected SLNs was 2 (range 1-5). 8 of 17 (47%) patients had radioactive nodes only in the paraaortic area. Synchronic appearance of SLNs in the pelvic and paraaortic areas was detected in 1 of 17 (6%) cases. Overall, in 4 of 9 (44%) cases of sentinel lymph node localization in the paraaortic area the SLNs were detected at the level above the inferior mesenteric artery. The metastatic involvement of 3 sentinel lymph nodes was detected in one patient (3 lymph nodes with micrometastases). All the remaining lymph nodes not labelled as SLNs were histologically negative in this case. The sensitivity and specificity for SLN metastases detection was 100%. CONCLUSION: SLN detection in endometrial cancer appears to be a promising method with the potential to reduce unnecessary surgery radicality and to clarify staging. The utilization of hysteroscopic application of radiocolloid respects the anatomical consequences and natural lymphatic drainage of the endometrium. The combination of pre-operative lymphoscintigraphy and intra-operative detection using a handheld gamma probe can be beneficial.
- MeSH
- biopsie sentinelové lymfatické uzliny * MeSH
- hysteroskopie * MeSH
- karcinom patologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfatické metastázy MeSH
- lymfatické uzliny diagnostické zobrazování MeSH
- nádory endometria patologie chirurgie MeSH
- radiofarmaka MeSH
- radioisotopová scintigrafie MeSH
- senioři MeSH
- technecium 99mTc-agregovaný albumin MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- radiofarmaka MeSH
- technecium 99mTc-agregovaný albumin MeSH
- technetium Tc 99m nanocolloid MeSH Prohlížeč
- MeSH
- infekce papilomavirem prevence a kontrola MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- vakcinace * MeSH
- vakcíny proti papilomavirům * MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- vakcíny proti papilomavirům * MeSH
