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Fonseca FV, Cordeiro MVG, Pozza AC, Maestri CA. Cervical Intraepithelial Neoplasia: Analyzing the Disease Present Exclusively in the Endocervical Canal. Rev Bras Ginecol Obstet 2022; 44:385-390. [PMID: 35276746 PMCID: PMC9948066 DOI: 10.1055/s-0042-1743102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the role of cervical cytology (Pap smear) in the diagnosis of cervical intraepithelial neoplasia 2 or greater (CIN2 + ), presented exclusively in the endocervical canal, the clinical-epidemiological characteristics of this lesion, the necessary length of canal to be removed to treat, and the rate of invasive lesion hidden in the endocervical canal. METHODS Cross-sectional study, by database analysis, of patients with abnormal cytology (high-grade squamous intraepithelial lesion [HSIL]), without visible colposcopy lesion, submitted to loop electrosurgical procedure (LEEP) to evaluate the association of cytology results with the histological product of the conization, to identify the epidemiological characteristics of endocervical lesion and clinical evolution, using a p-value < 0.05 and 95% CI. RESULTS In 444 cases, the Pap smear sensitivity for CIN2+ diagnosis was 75% (95% CI: 69.8-79.7), specificity was 40% (95% CI: 30.2-49.5), and the prevalence rate of histological lesion was 73% (95% CI: 70.1-78.7). There was a higher prevalence of CIN2+ in women over 42 years old and invasive cancer in those over 56 years old (p < 0.001), and it was necessary to remove 2.6 cm in length of the canal to reduce the chance of recurrence (p < 0.006). The rate of invasive cancer was 2.7%. CONCLUSION Cytology was related to a high prevalence to histological lesion (73%) in the diagnosis of CIN2+ in the endocervical disease; older patients presented a higher relationship with histological lesions in the canal disease, and it was necessary to remove an average of 2.6 cm in length of the endocervical canal to avoid the persistence and progression of CIN. The rate of occult neoplasia in the endocervical canal was 2.7%.
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Affiliation(s)
| | | | | | - Carlos Afonso Maestri
- Department of Gynecology and Obstetrics, Universidade Positivo, Curitiba, PR, Brazil
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Teixeira JC, Maestri CA, Machado HDC, Zeferino LC, de Carvalho NS. Incidence rates and temporal trends of cervical cancer relating to opportunistic screening in two developed metropolitan regions of Brazil: a population-based cohort study. SAO PAULO MED J 2019; 137:322-328. [PMID: 31691764 PMCID: PMC9744015 DOI: 10.1590/1516-3180.2018.0306220719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 07/22/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Brazilian opportunistic screening programs for cervical cancer have limited impact. In the regions of two cities (Campinas and Curitiba) with high human development indices, consistent information from 96-97% of all cervical cancer cases managed within the public healthcare system is available. OBJECTIVE To estimate the incidence rate (IR) and temporal trends in these regions, covering 2001-2012. DESIGN AND SETTING A population-based cohort study was conducted under the assumption that all cervical cancer cases were managed in cancer referral center hospitals. METHODS 3,364 records (1,646 from Campinas; 1,718 from Curitiba) were analyzed to provide estimates of IR, age-standardized IR (ASR) and cervical cancer trends (shown per 100,000 women/year). Longitudinal patterns were analyzed using linear regression and shown as annual percentage change (APC); P < 0.05 for significance. RESULTS Annual IR and ASR estimates for cervical cancer ranged from 3.8 to 8.0 over 2001-2012, decreasing over more recent years, and were similar for the two regions. The age-specific IR was about 50% lower among women aged 45 years or older (IR-2001/IR-2012: Campinas = 14.8/8.0; Curitiba = 18.7/8.3; P < 0.001). There was an increasing APC trend in Campinas among women aged 15-24 years, and a decreasing IR trend for squamous-cell histology in both regions (P < 0.05). CONCLUSION Cervical cancer incidence estimates showed slowly decreasing trends in both regions, most evidently for women aged 45 years or older and for squamous-cell histology. These findings reflect the opportunistic nature of the population screening program, despite the comparatively high economic development level in the two regions.
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Affiliation(s)
- Júlio César Teixeira
- MD, PhD. Physician and Assistant Professor, Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Carlos Afonso Maestri
- MD, MSc. Physician and Doctoral Student, Lower Genital Tract Disease Service, Hospital Erasto Gaertner, Curitiba (PR), Brazil.
| | - Helymar da Costa Machado
- MSc. Statistician, Department of Statistics, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Luiz Carlos Zeferino
- MD, PhD. Physician and Professor, Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Newton Sérgio de Carvalho
- MD, PhD. Physician and Professor, Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Federal do Paraná (UFPR), Curitiba (PR), Brazil.
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Maestri CA, Nisihara R, Mendes HW, Jensenius J, Thiel S, Messias-Reason I, de Carvalho NS. MASP-1 and MASP-2 Serum Levels Are Associated With Worse Prognostic in Cervical Cancer Progression. Front Immunol 2018; 9:2742. [PMID: 30532757 PMCID: PMC6265985 DOI: 10.3389/fimmu.2018.02742] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 11/07/2018] [Indexed: 12/11/2022] Open
Abstract
Background: MBL-associated serine proteases (MASP-1, MASP-2, MASP-3, MAp-44, and MAp-19) are key factors in the activation of the lectin pathway of complement. Serum levels of these components have been associated with recurrence and poor survival of some types of cancer, such as colorectal and ovarian cancer. In this investigation, we determined the serum levels of MASP-1, MASP-2, MASP-3, MAp-44, and MAp-19 in patients with cervical cancer and cervical intraepithelial neoplasia (CIN). Methods:A total of 351 women who underwent screening for cervical cancer or treatment at the Erasto Gaertner Cancer Hospital in Curitiba-Brazil, were enrolled in the study. Based on their latest cervical colposcopy-guided biopsy results, they were divided into four groups: CIN-I: n = 52; CIN-II: n = 73; CIN-III: n = 141; and invasive cancer: n = 78. All the serum protein levels were determined by time-resolved immunofluorometric assay (TRIFMA). Results:Patients with invasive cancer presented significantly higher MASP-2, MASP-1, and MAp-19 serum levels than other groups (p < 0.0001; p = 0.012; p = 0.025 respectively). No statistically significant differences in MASP-3 and MAp-44 serum levels were found between the four studied groups. In addition, high MASP-2, MASP-1, and MAp-19 serum levels were significantly associated with poor survival in patients with invasive cancer and relapse (p = 0.002, p = 0.0035 and p = 0.025, respectively). Conclusion:High MASP-2, MASP-1, and MAp-19 serum levels were associated with cervical cancer progression and worse disease prognosis. These novel findings demonstrate the involvement of the serine proteases of the lectin pathway in the pathogenesis of cervical cancer and future investigations should clarify their role in the disease process.
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Affiliation(s)
- Carlos Afonso Maestri
- Liga Paranaense de Combate ao Câncer, Erasto Gaertner Hospital, Curitiba, Brazil.,Department of Medicine, Positivo University, Curitiba, Brazil
| | - Renato Nisihara
- Department of Medicine, Positivo University, Curitiba, Brazil.,Immunopathology Laboratory, Department of Clinical Pathology, Federal University of Parana, Curitiba, Brazil
| | - Hellen Weinschutz Mendes
- Immunopathology Laboratory, Department of Clinical Pathology, Federal University of Parana, Curitiba, Brazil
| | - Jens Jensenius
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Stephen Thiel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Iara Messias-Reason
- Immunopathology Laboratory, Department of Clinical Pathology, Federal University of Parana, Curitiba, Brazil
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Nisihara R, Machoski MCC, Neppel A, Maestri CA, Messias-Reason I, Skare TL. Anti-nuclear antibodies in patients with breast cancer. Clin Exp Immunol 2018; 193:178-182. [PMID: 29645079 DOI: 10.1111/cei.13136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2018] [Indexed: 10/17/2022] Open
Abstract
To study the prevalence of anti-nuclear antibodies (ANA) in breast cancer patients and its association with tumour characteristics. Ninety-one patients with breast mass detected by image studies and assigned to conduct diagnostic biopsy and eventual surgical treatment were studied for demographical, tumour data and presence of ANA. Serum of positive ANA patients was screened for the extractable nuclear antigen (ENA) profile. As comparison, 91 healthy individuals matched for age and from the same geographical area were included. In this sample 72 of 91 (79·1%) had malignant lesions (83% ductal infiltrative carcinoma). ANA was positive in 44·4% of patients with malignant tumour and in 15·7% of those with benign lesions (malignant versus benign with P = 0·03). Controls had ANA positivity in 5·4%, and when compared with tumour samples showed P < 0·0001. The most common immunofluorescence pattern was a fine dense speckled pattern. In the ANA-positive patients with malignant lesions, seven had positivity for ENA profile (three for anti-RNP and anti-Sm, one for just anti-RNP, two for anti-Ro and anti-La e two for just anti-La). It was not possible to associate ANA positivity with tumour histological characteristics or staging or with patient's age. A negative association of ANA with hormonal (oestrogen or oestrogen plus progesterone) receptor status was found (P = 0·01). In this sample, there was a high prevalence of ANA positivity in breast cancer patients with a negative association with the presence of hormonal receptors. More studies are needed to understand the real value of this finding.
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Affiliation(s)
- R Nisihara
- Medicine Department, Positivo University, Curitiba, Brazil.,Medicine Department, Evangelical University, Curitiba, Brazil
| | - M C C Machoski
- Medicine Department, Evangelical University, Curitiba, Brazil
| | - A Neppel
- Medicine Department, Evangelical University, Curitiba, Brazil
| | - C A Maestri
- Erasto Gaertner Hospital, Liga Paranaense de Combate ao Câncer, Curitiba, Brazil.,Immunopathology Laboratory, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil
| | - I Messias-Reason
- Immunopathology Laboratory, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil
| | - T L Skare
- Medicine Department, Evangelical University, Curitiba, Brazil
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Maestri CA, Bettotti P, Scarpa M. Fabrication of complex-shaped hydrogels by diffusion controlled gelation of nanocellulose crystallites. J Mater Chem B 2017; 5:8096-8104. [PMID: 32264648 DOI: 10.1039/c7tb01899a] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In this study we investigated the fabrication of small hydrogel objects by the coordination-driven assembly of supramolecular rod-like crystallites of nanocellulose, using ionotropic gelation as a methodological approach and Ca2+ as a gelling agent. We proved that the gelation process is diffusion-mediated and fitting the equations modelling this process to the profile of the Ca2+ front, a Ca2+ diffusion coefficient in the incipient hydrogel of (4.5 ± 1.1) × 10-6 cm2 s-1 was calculated. At the steady-state a spatially homogeneous distribution of Ca2+-crosslinked sites in the hydrogel network was observed. External ionotropic gelation produced beads, wires or disks, while core-shell capsules were obtained by inverse ionotropic gelation. We demonstrated that equilibrium and dynamics of the distribution of Ca2+ offer the opportunity to design precisely the size and shape of these small hydrogel objects. In particular, the core size and the shell thickness of the capsules can be tailored under kinetic controlled conditions. The proposed approach, with supramolecular structures of the natural source as assembling components and the water-in-water fabrication process, is fast, simple, and requires only sustainable chemistry and is easily implementable in automatic microfluidic platforms.
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Affiliation(s)
- C A Maestri
- Nanoscience Laboratory, Department of Physics, University of Trento, Via Sommarive 14, I-38123 Povo TN, Italy.
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Maestri CA, Abrami M, Hazan S, Chistè E, Golan Y, Rohrer J, Bernkop-Schnürch A, Grassi M, Scarpa M, Bettotti P. Role of sonication pre-treatment and cation valence in the sol-gel transition of nano-cellulose suspensions. Sci Rep 2017; 7:11129. [PMID: 28894262 PMCID: PMC5593908 DOI: 10.1038/s41598-017-11649-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/18/2017] [Indexed: 11/23/2022] Open
Abstract
Sol-gel transition of carboxylated cellulose nanocrystals has been investigated using rheology, SAXS, NMR and optical spectroscopies to unveil the distinctive roles of ultrasound treatments and addition of various cations. Besides cellulose fiber fragmentation, sonication treatment induces fast gelling of the solution. The gelation is independent of the addition of cations, while the final rheological properties are highly influenced by the type, concentration and sequence of the operations since the cations must be added prior to sonication to produce stiff gels. The gel elastic modulus was found to increase proportionally to the ionic charge rather than the cationic size. In cases where ions were added after sonication, SAXS analysis of the Na+ hydrogel and Ca2+ hydrogel indicated the presence of structurally ordered domains in which water is confined, and 1H-NMR investigation showed the dynamics of water exchange within the hydrogels. Conversely, separated phases containing essentially free water were characteristic of the hydrogels obtained by sonication after Ca2+ addition, confirming that this ion induces irreversible fiber aggregation. The rheological properties of the hydrogels depend on the duration of the ultrasound treatments, enabling the design of programmed materials with tailored energy dissipation response.
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Affiliation(s)
- C A Maestri
- Nanoscience Laboratory, Department of Physics, University of Trento, Via Sommarive 14, 38123, Povo (TN), Italy
| | - M Abrami
- Department of Engineering and Architecture, University of Trieste, Piazzale Europa 1, 34127, Trieste, Italy
| | - S Hazan
- Ilse Katz Institute for Nanoscale, Science and Technology, Ben Gurion University of the Negev, Beer Sheva, 84105, Israel
| | - E Chistè
- Nanoscience Laboratory, Department of Physics, University of Trento, Via Sommarive 14, 38123, Povo (TN), Italy
| | - Y Golan
- Ilse Katz Institute for Nanoscale, Science and Technology, Ben Gurion University of the Negev, Beer Sheva, 84105, Israel
- Department of Materials Engineering, Ben Gurion University of the Negev, Beer Sheva, 84105, Israel
| | - J Rohrer
- Department of Pharmaceutical Technology, Institute of Pharmacy, University of Innsbruck, Innrain 80/82, Innsbruck, Austria
| | - A Bernkop-Schnürch
- Department of Pharmaceutical Technology, Institute of Pharmacy, University of Innsbruck, Innrain 80/82, Innsbruck, Austria
| | - M Grassi
- Department of Engineering and Architecture, University of Trieste, Piazzale Europa 1, 34127, Trieste, Italy
| | - M Scarpa
- Nanoscience Laboratory, Department of Physics, University of Trento, Via Sommarive 14, 38123, Povo (TN), Italy
| | - P Bettotti
- Nanoscience Laboratory, Department of Physics, University of Trento, Via Sommarive 14, 38123, Povo (TN), Italy.
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Maestri CA, Nisihara R, Ramos GP, Weinschutz Mendes H, Messias-Reason I, de Carvalho NS. Mannose-Binding Lectin Does Not Act as a Biomarker for the Progression of Preinvasive Lesions of Invasive Cervical Cancer. Med Princ Pract 2017; 26:530-534. [PMID: 29131134 PMCID: PMC5848474 DOI: 10.1159/000485037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 11/07/2017] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To evaluate serum concentrations of mannose-binding lectin (MBL) in women presenting with different human papillomavirus (HPV)-associated cervical lesions. SUBJECTS AND METHODS A total of 364 women, who underwent screening for cervical cancer or treatment at the Erasto Gaertner Cancer Hospital (HEG), Curitiba, Brazil, were enrolled in the study. Based on the latest cervical colposcopy-guided biopsy results, the women were divided into 4 groups: cervical intraepithelial neoplasia CIN-I (n = 54), CIN-II (n = 72), CIN-III (n = 145), and invasive cancer (n = 93). A time-resolved immunofluorometric assay was used to measure the MBL concentrations in serum. The statistical analysis was done using GraphPad Prism 6.0. Comparisons were performed by Kruskal-Wallis and Mann-Whitney tests and analyzed by χ2 test; continuous variables are presented as medians and categorical variables as frequencies. RESULTS The median MBL concentrations in decreasing order were as follows: invasive cancer: 1,452 ng/mL, CIN-I: 1,324 ng/mL, CIN-II: 1,104 ng/mL, and CIN-III 1,098 ng/mL. However, no statistical significance was found among the 4 groups with HPV-associated lesions (p = 0.11). Equally, the MBL levels did not show a significant association between the age of the patients and the severity of the cervical lesions (p = 0.68). No statistical significance was found in the median values of MBL or in the status of MBL deficient (<100 ng/mL) and high producers (>1,000 ng/mL) among the women in each group (p = 0.77). CONCLUSION In this study, there was no statistically significant difference in MBL serum levels among the groups with CIN. Hence MBL serum concentration appeared not to have influenced the progression of HPV-related preinvasive cervical lesions into invasive cancer.
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Affiliation(s)
- Carlos Afonso Maestri
- Liga Paranaense de Combate ao Câncer, Erasto Gaertner Hospital, Federal University of Parana, Curitiba, Brazil
| | - Renato Nisihara
- Immunopathology Laboratory, Clinical Hospital, Federal University of Parana, Curitiba, Brazil
- *Dr. Renato Nisihara, Immunopathology Laboratory, Clinical Hospital, Federal University of Parana, R. Prof. Pedro Viriato Parigot de Souza, 5300, Curitiba, PR 81280-330 (Brazil), E-Mail
| | - Guilherme P. Ramos
- Department of Gynecology, Clinical Hospital, Federal University of Parana, Curitiba, Brazil
| | | | - Iara Messias-Reason
- Immunopathology Laboratory, Clinical Hospital, Federal University of Parana, Curitiba, Brazil
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Fonseca FV, Tomasich FDS, Jung JE, Maestri CA, Carvalho NSD. The role of P16ink4a and P53 immunostaining in predicting recurrence of HG-CIN after conization treatment. Rev Col Bras Cir 2016; 43:35-41. [DOI: 10.1590/0100-69912016001008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 12/08/2015] [Indexed: 05/29/2023] Open
Abstract
Objective: Io evaluate the expression of p16INK4a and p53 biomarkers in conization specimens from patients with high grade cervical intraepithelial neoplasia (HG-CIN), correlating them with the ability to predict the recurrence. Methods : we conducted a retrospective study of patients with HG-CIN in cervical biopsy treated with conization between January 1999 and January 2006 who had a minimum follow-up of 18 months. The expression of the p16 and p53 was assessed by tissue microarrays and correlated with disease recurrence. For analysis, we used the test of proportions (chi-square), considering value p<0.05, 95% CI and calculations of sensitivity, specificity and accuracy of these immunomarkers in predicting recurrence. Results : the series comprised 83 patients aged between 16 and 86 years (35±11.7), divided into two groups: 30 with HG-CIN recurrence (study group) and 53 without recurrence (control group). Mean age, parity, smoking and conization technique were similar in both groups. The p53 expression was present in 43% of the study group and 57% of the control group, and the p16 was present in 43% of the study group and in 57% of the control group (p>0.05). p53 had a positive predictive value (PPV) of 42% and negative predictive value (NPV) of 73%, sensitivity 70%, specificity of 47% and accuracy of 59%. The p16, PPV 42%, NPV 72%, sensitivity 66%, specificity of 49% and accuracy of 56%. Conclusion : immunohistochemistry expression of p53 and p16 showed low sensitivity and low specificity as predictors of HG-CIN recurrence after conization treatment.
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Preti VB, Hatschbach SBB, Linhares JC, Guerreiro JA, Minari CL, Maestri CA, Fonseca FV. [A borderline ovarian tumor in inguinal canal: case report]. Rev Bras Ginecol Obstet 2010; 32:293-7. [PMID: 20945015 DOI: 10.1590/s0100-72032010000600007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 05/26/2010] [Indexed: 11/21/2022] Open
Abstract
The symptoms of ovarian tumor are not specific and a rare presentation of the tumor is as the content of an inguinal hernia. We reported a case of an 82-year-old woman, diagnosed with breast cancer and with a concomitant hypoecoic adnexal mass at the ecographic exam. The patient was treated with conservative breast surgery and laparotomy. A cystic-solid ovarian lesion was found inside the right inguinal canal. Frozen-section examination was negative for malignancy, and the anatomopathological analysis revealed a borderline ovarian tumor.
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Preti VB, Hatschbach SBB, Linhares JC, Guerreiro JA, Minari CL, Maestri CA, Fonseca FV. [High-grade cervical intraepithelial neoplasia during pregnancy: experience in a service in southern Brazil]. Rev Bras Ginecol Obstet 2009; 31:604-608. [PMID: 20101375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 12/03/2009] [Indexed: 05/28/2023] Open
Abstract
PURPOSE to evaluate the results of treatment to which patients with high grade intraepithelial cervical neoplasia (HSIL) are submitted, as well as their follow-up during pregnancy. METHODS retrospective study based on the review of the medical report of 30 patients with diagnosis of high-grade squamous intraepithelial lesions (HSIL) during pregnancy and attended to at a tertiary hospital in southern Brazil from 1990 to 2002. Diagnosis was performed by colposcopy and biopsy, with repetition of the colposcopy during the pregnancy and after delivery. The diagnoses of regression and progression of lesions were evaluated. RESULTS from 30 patients, 3 were excluded of the sample because the diagnosis of high-grade squamous intraepithelial lesions (HSIL) was not confirmed by the colposcopy with biopsia. Four patients were submitted to treatment during pregnancy, and one of them presented preterm delivery at the 32nd week. Twenty-three patients were submitted to expectant treatment, underwent a new colposcopy and biopsy, and then were submitted to conisation surgery at about the 11(th) week after the end of pregnancy. In 7.4% of the cases, there was lesion regression in the surgical specimen. CONCLUSIONS all patients with diagnosis should be submitted to colposcopy and biopsy to exclude the possibility of invasive lesion. The expectant procedure for intraepithelial lesions is the most widely chosen and safe due to the possibility of regression in the postpartum period.
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