The relationship of immunohistochemical SOX-2 staining with histopathological diagnosis in patients with abnormal colposcopic findings

This study aimed to analyze immunohistochemical staining and pathological data in cervical intraepithelial neoplasia (CIN) and squamous cell cervical carcinoma (SCC) with abnormal colposcopic findings. A histopathological evaluation of 45 low-grade squamous lesions (LSILs), 177 high-grade squamous lesions (HSILs) and 16 SCC biopsy materials from existing slides was obtained from blocks obtained from the archive. In addition, SOX-2 immunohistochemical staining was evaluated. The mean age of the HSIL group was 43.20 ± 8.97 years, younger than the mean age of the LSIL group of 51.62 ± 9.64 years (p = 0.000). There was no difference between the groups regarding the method of biopsy (p > 0.05). Endocervical gland involvement was not observed in the LSIL group, but was observed in 66 (37.3%) biopsy materials in the HSIL group (p = 0.000). There was a difference between the groups in terms of the level of CIN at the surgical margin (p = 0.000). Ki-67, SOX-2 staining percentage and p16INK4a positivity were higher in the HSIL group than in the LSIL group (respectively, 67.57 ± 19.10 vs. 14.62 ± 7.11, p = 0.000; 27.72 ± 31.56 vs. 10.09 ± 15.38, p = 0.003; 66 (82.5%) vs. 8 (44.4%), p = 0.001). While there was no difference in SOX-2 intensity between the HSIL and LSIL groups (p > 0.05), it was statistically significantly higher in the SCC group (p = 0.000), as was the percentage of SOX-2 (p = 0.000). We have shown that p16INK4a and SOX-2 staining is useful, in addition to Ki-67 immunostaining, which is widely used for SCC, which is one of the preventable cancer types. In addition, SOX-2 may provide a glimmer of hope in the development of SCC treatment modalities, especially since it is aggressively elevated in SCC rather than CIN lesions.

Is the Anal Component of the Anogenital HPV-Related Disease Overlooked During the Surveillance of Patients Treated for Cervical Intraepithelial Neoplasia?

AIM

To investigate the anal component of the anogenital Human Papillomavirus (HPV) related disease during surveillance of patients treated for cervical intraepithelial neoplasia (CIN).

METHODS

Patients were analyzed within two groups according to the histopathological examination of the cervical biopsies: Low-Grade Squamous Intraepithelial Lesion (LSIL) and High-Grade Squamous Intraepithelial Lesion (HSIL) groups. Anal specimens were also collected in the first-year follow-up visit.

RESULTS

All patients had cervical high-risk HPV (HR HPV) infection at admission. At the first-year follow-up, positive HR HPVs were found in 47% of cervical samples. Despite this clearance, the anal HPV infection rate after the first year was 42.5% and 39.6% in LSIL and HSIL groups. Amongst the HSIL group, anal HR HPV positivity was observed in 29.6% of cases without any cervical HPV infection.

CONCLUSION

A group of women cured of high-grade lesions have ongoing anal HPV infection. It is reasonable to propose that detecting anal HPV could impact the patient's treatment process. Therefore, prospective studies are needed to investigate this group of women's clinical outcomes and define the clearance rate of cervical HPV infection when anal HPV persists.

Role of F-18 FDG PET/CT in Predicting Response to Neoadjuvant Chemotherapy in Invasive Ductal Breast Cancer

Objective:

The role of baseline and post-treatment standardized uptake value (SUV_max) values in predicting pathological response in patients with breast cancer after neoadjuvant chemotherapy (NAC).

Materials and Methods:

Thirty patients with invasive ductal breast cancer were included in this retrospective study. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) examinations were performed before and after NAC. Pretreatment SUV_max (SUV_max I), post-treatment SUV_max (SUV_max II) and ΔSUV_max values of primary breast cancer were obtained. Breast tumor pathology preparations were examined for the evaluation of tumor response according to the Miller and Payne classification. Patients were grouped as responding to treatment (pCR) and unresponsive to treatment (nonpCR). In all analyses, p<0.05 was considered statistically significant.

Results:

The mean age of the 30 patients included in the study was 51.2±11.98 years. In the study-defined grouping, 13 patients (43.3%) were nonresponders and 17 patients (56.7%) were responders. ΔSUV_max was significantly greater in the responders group compared to the nonresponders group, while SUV_max II was lower (p = 0.001 and p = 0.004, respectively). There was no significant difference between the responders and nonresponders in terms of age, tumor diameter, and SUV_max I values. Multivariate logistic regression analysis showed ΔSUV_max to be the only independent predictive factor for pCR.

Conclusion:

F-18 FDG PET/CT was an effective method in evaluating the treatment response after NAC in breast cancer, and ΔSUV_max and post-treatment SUV_max can be used to predict the response of the primary tumor to treatment.

Microarray expression results of VEGF, YAP1 and PTEN immunostains in preeclampsia cases

We aimed to evaluate the expression of YAP1, PTEN, VEGF in the placentas of patients with preeclampsia and placentas of healthy pregnant women for trophoblast invasion, which is similar to cancer etiopathogenesis. The placentas of 70 women who gave birth, including 30 preeclampsia and 40 healthy controls, were evaluated. YAP1, PTEN and VEGF immunohistochemical staining were performed using the microarray method on placental tissue. The mean ± standard deviation for YAP1, PTEN and VEGF intensity were; 1.57 ± 0.71,2.59 ± 0.80, 1.61 ± 0.59, respectively. PTEN intensity was statistically significantly lower in the preeclampsia group than in the control group (2.37 ± 0.99 vs 2.75 ± 0.58, p = .049). There was no difference between the groups in terms of YAP1 and VEGF staining (p > .05). The etiopathogenesis of preeclampsia is still unclear. However, since trophoblast invasion and endothelial repair have similar aspects with cancer mechanisms, both preeclampsia and cancer studies are progressing by supporting each other. Our study is a prototype study showing that large-participation studies can be carried out easily by using the microarray method as an economic model.

CD97 expression level and its effect on cell adhesion in Preeclampsia

OBJECTIVES

Cellular interactions and cell adhesion underlie preeclampsia (PE). The aim of the current study is to investigate the role of cell adhesion molecules such as CD97, neural (N)-cadherin, epithelial (E) -cadherin and integrin beta-4 in PE.

METHODS

This prospective study included 20 pregnant women with PE and a control group of 16 healthy pregnant women who were matched for age, gestational age, gravida and parity. Standard blood tests and placental cell adhesion molecule immunohistochemical staining were examined.

RESULTS

The creatinine, uric acid and lactate dehydrogenase (LDH) levels from standard blood tests were found to be statistically higher in the PE group (p = 0.002, p = 0.000, p = 0.001; respectively). In the PE group, the CD97 maternal serum level was statistically significantly lower, as was its immunohistochemical expression in placental sections (p = 0.028, p = 0.000; respectively). The E-cadherin expression score was statistically higher in the PE group compared to the control group (3,65 ± 1,84 vs 2,06 ± 1,76 respectively; p = 0.003). The N-cadherin expression score was statistically lower in the PE group compared to the control group (1,50 ± 0,82 vs 2,43 ± 1,59 respectively; p = 0.049). Integrin beta-4 was not statistically different between groups.

CONCLUSIONS

Cellular interaction may be responsible for PE as in cancer. A balance in intercellular communication, as researched in cancer therapy, may offer the solution in PE.

Relationships of 18F-FDG uptake by primary tumors with prognostic factors and molecular subtype in ductal breast cancer

OBJECTIVES

In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients.

MATERIALS AND METHODS

We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent ¹⁸F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In ¹⁸F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype.

RESULTS

The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8,14 ± 3,71 and 4,64 ± 2,45, p = 0,002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r = 0,276, p = 0,001) and moderate correlation between tumor size and SUVmax (r = 0,470, p = 0,001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p = 0,004, Std Beta: 0,228, 95% CI:0,010-0,055 and p = 0,001, Std Beta:0,374, 95% CI:0,55-0,136, respectively).

CONCLUSION

High SUVmax value is associated with factors suggesting poor prognosis. Pretreatment ¹⁸F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer.

An Experimental Study on Timing in Tracheal Stenosis Surgery

Background TNF-α, IL-6, and TGF-β are important bio mediators of the inflammatory process. This experimental study has investigated inflammatory biomarkers' efficacy to determine the appropriate period for anastomosis surgery in tracheal stenosis cases.

Methods First, a pilot study was performed to determine the mean stenosis ratio (SR) after the surgical anastomosis. The trial was planned on 44 rats in four groups based on the pilot study's data. Tracheal inflammation and stenosis were created in each rat by using micro scissors. In rats of groups I, II, III, and IV, respectively, tracheal resection and anastomosis surgery were applied on the 2nd, 4th, 6th, 8th weeks after the damage. The animals were euthanized 8 weeks later, followed by histopathological assessment and analysis of TNF-α, IL-6, and TGF-β as biochemical markers.

Results Mean SR of the trachea were measured as 21.9 ± 6.0%, 24.1 ± 10.4%, 25.8 ± 9.1%, and 19.6 ± 9.2% for Groups I to IV, respectively. While Group III had the worst SR, Group IV had the best ratio (p = 0.03). Group II had the highest values for the biochemical markers tested. We observed a statistically significant correlation between only histopathological changes and TNF-α from among the biochemical markers tested (p = 0.02). It was found that high TNF-α levels were in a relationship with higher SR (p = 0.01).

Conclusion Tracheal anastomosis for post-traumatic stenosis is likely to be less successful during the 4th and 6th weeks after injury. High TNF-α levels are potentially predictive of lower surgical success. These results need to be confirmed by human studies.

Prevalence of oropharyngeal high-risk human papillomavirus in tumor-free tonsil tissue in adults

PURPOSE

To determine the prevalence of oropharyngeal high-risk human papillomavirus (HPV) in patients undergoing tonsillectomy by detection of high-risk HPV in tonsil tissues using the in situ hybridization (ISH) technique.

MATERIALS AND METHODS

The patients who underwent tonsillectomy between 2014 and 2018 were examined retrospectively. The pediatric cases and patients who underwent tonsillectomy due to malignancy were excluded. The study included 270 adult cases selected by age and gender randomization. The tonsillar tissue of each case was re-examined by the pathology department, and the presence of high-risk HPV was investigated via the ISH technique. Multiple logistic regression models were used for predictions of different factors.

RESULTS

The prevalence of high-risk HPV in the 270 patients (male: 154 [57%]; female: 116 [43%]; mean age: 36.44 ± 12.87 years) was found to be 6.7% (n = 18). The prevalence was found 8.4% in men and 4.3% in women; 8.9% in cases under the age of 40 and 2.9% in cases over the age of 40; and 10.9% in patients who underwent tonsillectomy for infectious indications and 2.3% for non-infectious indications. Multivariate analysis identified that the infectious indications for tonsillectomy were significantly associated with high-risk HPV positivity (OR 5.328; p = 0.009).

CONCLUSIONS

The prevalence of oropharyngeal high-risk HPV was found to be 6.7% and higher in younger people and men. Additionally, the HPV positivity was found to be higher in patients who underwent tonsillectomy for infectious indications. To our knowledge, this is the first study that reports the correlation between recurrent tonsil infections and HPV positivity in tonsil tissue.

Correlation of cyclin D1, HER2, and AMACR expressions with histologic grade in bladder urothelial carcinomas

Background and Objective

Bladder cancer is the ninth most common type of cancer worldwide. We aimed to investigate the relationship between tumor grade, lamina propria invasion, muscularis propria invasion, and lymphovascular invasion and human epidermal growth factor receptor 2 (HER-2), cyclin D1, and alpha-methyl-CoA racemase (AMACR) expressions in bladder cancer.

Materials and Methods

The study included patients who underwent complete TURBT. In total, 72 cases of bladder cancer diagnosed by two pathologists were selected. AMACR, HER-2, cyclin D1 expressions were detected immunohistochemically.

Results

The study population comprised 80% (57) males and 20% (15) females (mean age, 68 years). Further, 35 cases were noninvasive and 37 invasive urothelial carcinoma and 38 patients had low-grade tumor and 34 high-grade tumor. Intense immunostaining was observed with cyclin D1 for 75% tumors, AMACR for 39%, and HER-2 for 86%. High expressions of cyclin D1 and AMACR were observed in high-grade tumors (P < 0.05 and P < 0.005, respectively). High expression of HER-2 (2 and 3 positive) was found both at low- and high-grade tumors (84% and 88%, respectively).

Conclusion

Cyclin D1, AMACR expressions were found to be significant predictive factors of high-grade tumors. High Her-2 expression in patients with bladder carcinoma may indicate that they are potential targets for treatment. These markers may be important in determining prognosis of tumors and may be valuable for guiding treatment options.

Relationships of 18F-FDG uptake by primary tumors with prognostic factors and molecular subtype in ductal breast cancer

OBJECTIVES

In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients.

MATERIALS AND METHODS

We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent 18F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In 18F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype.

RESULTS

The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8.14±3.71 and 4.64±2.45, p=0.002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r=0.276, p=0.001) and moderate correlation between tumor size and SUVmax (r=0.470, p=0.001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p=0.004, Std Beta: 0.228, 95% CI: 0.010-0.055 and p=0.001, Std Beta: 0.374, 95% CI: 0.55-0.136, respectively).

CONCLUSION

High SUVmax value is associated with prognotic factors suggesting poor prognosis. Pretreatment 18F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer.

The relation of CD3, CD4, CD8 and PD-1 expression with tumor type and prognosis in epithelial ovarian cancers

OBJECTIVES

Ovarian cancer is a heterogeneous disease, where chronic inflammation plays a key role in carcinogenesis. In this study, it is aimed to analyze the relationship with prognosis and chemotherapy response to clinicopathologicalnvariables in epithelial ovarian cancers such as proliferation of PD-1 +, CD8 +, CD4 +, CD3 + T-lymphocytes infiltrating the tumor and tumor stroma.

MATERIAL AND METHODS

Seventy-six cases diagnosed with primary epithelial ovarian tumor from biopsy or surgical resection materials were included in the study. Immunreactivity of CD3, CD4, CD8, PD1 was evaluated immunohistochemically in lymphocytes in tumor infiltrating lymphocytes and stromal lymphocytes.

RESULTS

Seventeen (22.4%) of the cases were Type I, 59 (77.6%) of them were Type II ovarian carcinoma. PD-1 positivity was observed in stromal and intraepithelial lymphocytes in 22 (28.9%) of 76 cases. In the presence of PD-1 + T-lymphocytes that infiltrate tumor and stroma, disease-free survival are shorter (p = 0.037). The presence of stromal CD4 + and CD8 + T-lymphocytes was more common in late stage patients (p = 0.012, p = 0.036; respectively). The disease-free and overall survival rate was statistically significantly shorter in the presence of CD8 + T lymphocytes (p = 0.009, p = 0.003; respectively).

CONCLUSIONS

CD3, CD4 and CD8 may contribute to PD-1 mediated tumor control. Anti PD-1 therapy may be an alternative to chemotherapy in PD-1 positive patients. Identifying patients who do not respond to chemotherapy through PD-1 expression prior to immunotherapy will help develop potential personalized immunotherapy.

Phyllodes Tumors of the Breast: A Single-Center Experience

Objective

We aimed to analyze the clinicopathological findings, treatment approach, and treatmen outcomes in patients diagnosed with phyllodes tumor (PT).

Materials and Methods

The clinicopathological data of 26 patients with PT, who were treated between 2008 and 2019, were retrospectively analyzed.

Results

Mean age was 35.07±13.95 years (range: 14-71), while mean tumor size was 54.76±29.24 mm (range: 25-135). Benign, borderline, and malignant PT were detected in 18 (69.2%), 3 (11.5%), and 5 (19.2%) patients, respectively. Marginless excision was performed in 20 patients (76.9%), while six (23.1%) patients underwent mastectomy. A statistically significant correlation of tumor type with mean tumor size and mean age was observed (p=0.041 and p=0.013, respectively). Margin positivity on first excision was more frequent in the malignant tumors (p=0.02). No statistically significant correlation of PT type with presence of breast cancer in the family history, and tumor localization was observed (p=0.79 and p=0.13, respectively). Mean postoperative follow-up duration was 56 months (range: 6-147). Local recurrence was not observed in any of the patients. Lung and left vastus lateralis muscle metastases were encountered. The patient with lung metastasis became exitus because of the same reason 6 months after detection of the metastasis.

Conclusion

PT is a rare fibroepithelial tumor of the breast that is characterized by a mixed histology seen in younger ages when compared to the classical breast tumors. The probability of PT should be considered in the presence of a rapid-growing mass in the breast. In addition, it should also be considered that the contribution of imaging techniques may be limited.

Predictors of Human papillomavirus (HPV) persistence after treatment of high grade cervical lesions; does cervical cytology have any prognostic value in primary HPV screening?

OBJECTIVE

This study aimed to determine the factors associated with Human Papillomavirus (HPV) persistence in women undergoing cervical excision for pre-invasive lesions, after they have been referred from a primary HPV screening program.

METHODS

A retrospective study design involving patients who were treated at a Cervical Disease Screening and Treatment Unit, in a university hospital setting. After initial treatment, cervical HPV infection status was analyzed at the sixth month, first year and then subsequently after the second year.

RESULTS

Totally, 395 patients who were diagnosed with pre-invasive cervical lesions and who subsequently undergone cervical excision were identified. In the first-year visit after cervical excision, HPV 18 was cleared in almost all (95.8%) cases, followed by HPV 16 (69.9%) and other hrHPV types (65.6%). Available data documented that 88.6% of women reached clearance after the two-year follow-up. Univariate analysis revealed a significantly higher proportion of HPV clearance among women who were younger (p = 0.019), premenopausal (p = 0.002), and who had been found to have a negative cytology result on their initial Pap test (p = 0.018). However, only cervical cytology result remained as the independent predictor of HPV persistence on a multivariate logistic regression (OR 0.43; 95% CI 0.21-0.87; p = 0.019).

CONCLUSIONS

A low risk of HPV persistence was found among every HPV genotype in women undergoing cervical excision for pre-invasive cervical lesions. Initial cervical cytology result was the only independent predictor of HPV clearance during surveillance, which indicates the prognostic value of Pap test in primary HPV screening.

Association of intra-tumoral tumour-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio is an independent prognostic factor in non-small cell lung cancer

BACKGROUND

Studies suggest that tumour-infiltrating lymphocytes (TILs) and inflammation markers have independent roles in non-small cell lung cancer (NSCLC), but the relationship between the two pronostic factors remains unclear. In this study, we investigated TILs and inflammation markers in with patients advanced stage NSCLC and assessed the association of their levels with prognosis.

MATERIALS AND METHODS

TILs were evaluated by immunohistochemical staining for cluster of differentiation 3 (CD3) and cluster of differentiation 5 (CD5) and by hematoxylin and eosin staining for non-specific lymphocyte. We investigated the localisation pattern of TILs in advanced stage NSCLC. We divided all cases into two groups: TILs-high and TILs-low groups, by 75th percentile of the population of. In our study, inflammation markers were assessed by C-reactive protein (CRP) and the neutrophil-to-lymphocyte ratio (NLR).

RESULTS

The results showed that the presence of intra-tumoral high CD3⁺ and low CD5⁺ were an independent prognostic factor for overall survival (respectively, P = 0.022 and P = 0.025). Moreover, the high NLR and serum high CRP levels were associated with poor survival (respectively, P = 0.008; P = 0.027). In multi-variate survival analysis, the high CD3⁺ , low CD5⁺ , high NLR, tumour node metastasis (TNM) stage, depth of tumour invasion and lymph node metastasis remained independent prognostic factors (respectively, P = 0.018, P = 0.020, P = 0.024, P = 0.038, P = 0.020 and P = 0.047).The high NLR was detected negative correlation with intra-tumoral CD3⁺ and positive correlation with intra-tumoral CD5⁺ (respectively, r = -0.623, P = 0.012; r = 0.628, P = 0.028).

CONCLUSIONS

This study is first report demonstrating the prognostic value of intra-tumoral low CD5⁺ with NSCLC. Increased CD3⁺ and low CD5⁺ was observed in patients with poor prognosis; the two molecules were correlated with NLR, suggesting that inflammation might be used as improve therapeutic efficacy to immunotherapy for advanced NSCLC.

Cervical cytological screening results of 8,495 cases in Turkey--common inflammation but infrequent epithelial cell abnormalities?

BACKGROUND

Cervical cancer is the ninth most common cancer among females in Turkey. Cervical smear is a routine screening test used for the detection of cervical abnormalities and also it detects certain infections of the cervix.

OBJECTIVE

To analyze cervical smear results of our clinic in order to determine most frequent pathology of the women in North Eastern Anatolia Region of Turkey.

MATERIALS AND METHODS

In a retrospective study design, 8,495 cervical cytology cases diagnosed at the Pathology Department of the Regional Education and Research Hospital in Erzurum over the last one and half years extending from August 2012 to December 2013 were investigated.

RESULTS

The most common diagnosis was found to be inflammation, 65.5 % (5,566 out of 8,495), and the least was squamous epithelial abnormalities 0.2% (13 out of 8,495). There was some variation among the three pathologists regarding diagnosis but findings for the latter.

CONCLUSIONS

Regular cervical smear tests are one of the most important strategies in early diagnosis of cervical cancer but there are conflicting data regarding the prevalence of epithelial cell abnormalities in Turkey, and the reasons of this should be investigated.

Effects of contraception on cervical cytology: data from Mardin City

OBJECTIVE

Mardin is an area of low socioeconomic level with low rates of contraceptive method use. Our aim in this study was to evaluate the effects of the contraceptive methods used in the area on epithelial cell abnormalities and vaginal flora changes.

MATERIAL AND METHOD

Cervical smear samples received at the Pathology Department between 2010 and 2012 of 526 patients who had used a contraceptive method and 112 who had never used one were included in the study. The cases were divided into 3 groups as those using hormonal contraception (107, 20.3%), those using an intrauterine device (343, 65.2%) and those using a barrier method (76, 14.4%). The evaluation was made using the Bethesda 2001 criteria for cervical epithelial abnormalities and specific cervicovaginal infections.

RESULTS

There was no significant difference between the groups for epithelial cell abnormalities while bacterial vaginitis (12%, p=0.03) and Trichomonas vaginalis (7.6%) were more common in the IUD users. The Actinomyces rate in RIA users was 1.3%. There was only 1 case of bacterial vaginitis in the barrier group and none of the other patients had a specific infection.

DISCUSSION

We did not find a significant cytopathic effect of using a IUD or hormonal contraception in our study. There was a low rate of epithelial abnormality in the barrier method group. IUD was seen to increase the incidence of bacterial vaginitis, Trichomonas vaginalis and Actinomyces. We did not find a significant effect of hormone use on the vaginal flora.

[The influence of cervicovaginitis agents on epithelial cell changes: comparison of Mardin city's data with the literature]

OBJECTIVE

The aim of this paper was to observe the reactive changes of epithelial cells exposed to the influence of cervicovaginitis agents that play an important role in the cytology practice and may cause an exaggerated appearance.

MATERIAL AND METHOD

378 cases with cervicovaginitis caused by a specific agent were compared with 100 control cases. It was recorded if the inflammation had concomitant cellular changes and atypia or not. After treatment, control smears were examined. The reactive and atypical situations of the cells were considered after the treatment. With the aid of the previous data, the answer to the following question was searched: Is epithelial atypia a real event or a reactive atypia that accompanies an existing cervicitis agent?

RESULTS

In the first interpretation, Candida group had the most frequent reactive and ASC-US (Atypic Squamous cells of Undetermined Significance) changes (56,4% and 59,5% respectively). The bacterial vaginosis and Trichomonas vaginalis groups showed ASC-US rates of 25% and 9,5% respectively while in control group the rate was 6,0%. After treatment, the number of cases of ASC-US decreased from 50 to 11. Similarly, the number decreased from 21 to 10 in the bacterial vaginosis group.

CONCLUSION

Cervicovaginitis agents need more attention because of their outcomes. Being aware of the cervicovaginitis agents during interpretation is essential for preventing a false positive diagnosis and unnecessary anxiety especially where cellular atypia is concerned.

Parachordoma: a recurrent case and review of the literature

Parachordoma is an uncommon tumor of soft tissue, and the origin is not clear. Recurrence and metastasis are rarely seen. A piecemeal mass measuring 7x4x3 cm was excised from a 28-year-man who had presented with pain and swelling of the right shoulder for 5 years. Histopathologically, the tumor was composed of cells with clear eosinophilic cytoplasm and an epithelioid appearance in a myxoid stroma separated by fibrous tissue with mild pleomorphism and mitotic activity. Tumoral cells were immunoreactive for cytokeratin 8/18, EMA, S-100 and vimentin, immunohistochemically. Recurrence was seen one year after the initial diagnosis. Areas of increased mitotic activity and atypical mitoses were observed in the recurrent tumor. We report this case as recurrence occurred earlier than usual and exhibited malignant features.