Cancer of the cervix in women under 40 years of age, a regional survey, 1975-1984
Article Abstract:
Motivated in part by the rising death rate from cervical cancer among women younger than 40 in England and Wales, a detailed study was carried out of the results of treatment of this disease in Yorkshire between 1975 and 1984. Data were obtained from the Yorkshire Regional Cancer Registry concerning all women who had been treated for carcinoma of the cervix (excluding microinvasive cancer) during that period. Four hundred twenty-eight records were obtained. The average age at the time of diagnosis was 32.7 years. The majority experienced symptoms consisting of post-coital or intermenstrual bleeding; many had a vaginal discharge. Pain was present in only 31 cases. Survival for five years was closely related to the stage at the time of diagnosis and ranged from 78.4 percent (stage IB) to zero (stage IV). Other important prognostic factors were metastasis to nodes and tumor grade. No differences in survival were seen that were related to patient age or to histological characteristics of the tumors. Most of the 181 women with stage IB or IIA disease who underwent surgical treatment had radical hysterectomy (removal of the uterus, ovaries and supporting structures) and removal of the pelvic lymph nodes, but some had less radical surgery (removal of uterus only). One hundred thirty-two women were treated mainly by radiation. Normal-appearing ovaries were removed in fewer cases in the later years of the study and external irradiation was given only if lymph node metastasis had occurred. Five-year survival for the surgery group was 81.9 percent; for the radiation therapy group, it was 73.1 percent; however, the tumor characteristics differed for these two groups. Tumors recurred in 75 of 313 cases. Recurrence was less common among women treated surgically than among those who received only radiation therapy. Those who received only radiation therapy had a higher rate of serious complications, such as bowel constriction and urinary tract complications. Most of these young women had their disease identified relatively early in its course: 65.2 percent had stage IB disease. The limitations of the statistical analyses in this report are stressed. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1991
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Clinical and prognostic significance of concanavalin-A-induced suppressor cell activity in malignant cervical neoplasia
Article Abstract:
Deficiencies in the immune response are associated with the development of certain diseases. The immune response involves the interaction of blood cells and a complex network of mediators. Specialized white blood cells called lymphocytes can either stimulate (helper cells) or suppress (suppressor cells) various aspects of the immune response. The relationship between suppressor cell activity and the development and prognosis of cervical cancer was studied among 229 patients in various stages of the disease. Blood samples were taken before and after radiotherapy treatment, and concanavalin-A-induced suppressor cell activity was measured. Suppressor cell activity before treatment corresponded well to the extent of the disease. Patients who remained disease-free six months after radiotherapy had a significant decrease in suppressor cell activity. Conversely, patients with evidence of recurrence maintained high suppressor cell activity compared with levels in the disease-free patients in comparable disease stages. The immune response of patients with recurrent disease appears to be altered, although the mechanism regulating suppressor cell activity is not clearly understood. It is suggested that concanavalin-A-induced suppressor cell activity can be used to predict the disease course in patients with cervical cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1990
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Prospective serial study of viral change in the cervix and correlation with human papillomavirus genome status
Article Abstract:
Although infection with human papillomavirus (HPV) has been implicated in cervical cancer, it is unlikely that HPV infection alone causes malignant change. This longitudinal prospective study investigated the serial nature of the changes in the cervix produced by HPV. Eighty-two women with changes in the cervix suggestive of HPV infection were studied with colposcopy (a device that uses a magnifying lens). Biopsies of cervical tissue were obtained at the initial examination and 9 and 18 months later for histologic analysis and examination of viral DNA. More advanced disease, cervical intraepithelial neoplasia - grade 3 (CIN 3) was treated with laser therapy. Ten percent of the subjects tested positive for HPV-16, the viral type most commonly encountered in the study area (Glasgow, Scotland.) Sixteen percent had CIN, a potentially malignant condition, although only two had CIN 3. CIN or viral infection as seen on histology did not correlate with the results of DNA analysis. In many cases, results of DNA analysis fluctuated from time to time, with the same patient testing positive at one time and negative at another. Thus, it appears that more than detection of the HPV-16 genome is required to investigate the role of this agent in cervical cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1991
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