Precancerous Conditions

El cáncer cervical es de los más diagnosticados y al mismo tiempo el más prevenible, ya que se han identificado con plenitud las diferentes etapas de su historia natural y se han desarrollado estrategias de prevención acorde a ellas. Sin embargo, esas estrategias no se ven reflejadas en la reducción de la morbilidad y la mortalidad en los países de bajos y medianos ingresos, debido a diferentes problemáticas tanto estructurales como individuales. En la presente revisión narrativa se explora la interacción entre la historia natural de la enfermedad, sus determinantes sociales y el enfoque del curso de vida, así que se analizan las barreras presentes para las estrategias de prevención, como la vacuna contra el virus del papiloma humano (VPH), el tamizaje y el tratamiento de lesiones cancerosas, propuestas en 2020 en la Estrategia Mundial para la Eliminación del Cáncer de Cuello Uterino, para sugerir cómo los esfuerzos intersectoriales pueden contribuir a disminuir las barreras de acceso en la prevención de esta enfermedad.

Uveal melanoma is a rare ocular malignancy with intrinsic resistance to conventional systemic chemoterapy. This study investigated paraffin embedded samples of 31 patient with primary choroidal and ciliary body melanoma in order to determine the presence of tumor cells that express putative cancer stem cell markers CD133, CD117 (c-kit), CD34, CD20 and CD15 and their possible impact on survival. Immunohistochemical expression of CD133 was observed in 16 of 22 samples with AEC chromogen. CD117 expression was observed in 12 of the 31 samples when AEC chromogen was used and in 14 of 26 samples when DAB was used. CD15 positivity was seen in 3 out of 30 samples with AEC and in 6 out of 26 samples with DAB. CD20 and CD34 exhibited no positivity in the tested samples. During the average follow-up time of 8.7 years, more than half of the patients died due to metastatic disease. The Kaplan-Meier plots showed a significantly shorter overall and disease-free survival in CD117-positive patients ...

Although in developed countries the incidence of colorectal cancer is decreasing through the introduction of well-designed screening systems, the worrying worldwide increase of the mortality rate by colorectal neoplasm indicates the need for a thorough characterization of this pathology. Clinical, endoscopic, histopathological and immunohistochemical data provide important information for creating categories of patients that can benefit from intensive screening methods and for establishing the prognosis based on these data. Approximately 80% of the colorectal cancer develops from adenomas, which shows that early detection of premalignant lesions is an important step in reducing global incidence and mortality. Our study aims at providing information about the clinical, imaging and histopathological characterization of colorectal neoplasm and premalignant lesions. A total of 98 patients were evaluated, including 72 patients diagnosed with colorectal cancer and 26 with premalignant les...

A recent review of economic studies relating to gastric cancer revealed that authors use different tests to estimate utilities in patients with and without gastric cancer. Our aim was to determine the utilities of gastric premalignant conditions and adenocarcinoma with a single standardized health measure instrument. Cross-sectional nationwide study of patients undergoing upper endoscopy (n=1,434) using the EQ-5D-5L quality of life (QoL) questionnaire. According to EQ-5D-5L, utilities in individuals without gastric lesions were 0.78 (95% confidence interval: 0.76-0.80), with gastric premalignant conditions 0.79 (0.77-0.81), previously treated for gastric cancer 0.77 (0.73-0.81) and with present cancer 0.68 (0.55-0.81). Self-reported QoL according to the visual analogue scale (VAS) for the same groups were 0.67 (0.66-0.69), 0.67 (0.66-0.69), 0.62 (0.59-0.65) and 0.62 (0.54-0.70) respectively. Utilities were consistently lower in women versus men (no lesions 0.71 vs. 0.78; premalignan...

Summary: This paper reviews our hospital's experience spanning 15 years and involving 811 women referred with abnormal cervical cytology in pregnancy. It supports the safety and accuracy of managing dysplasia in pregnancy with colposcopy, directed punch biopsy and deferral of treatment until the postpartum period. The histologically‐proven progression in pregnancy to a higher grade of dysplasia postpartum was 7%. None of the women are known to have developed microinvasive or invasive cancer between antenatal assessment and postpartum review. Of these 811 women, 16% were lost to follow‐up, 1 of whom subsequently represented 4 years later with invasive cervical cancer.

Pancreatic cancer is an aggressive tumor with a very poor prognosis, lack of early diagnostic symptoms and highly resistant to therapy. Its incidence is approximately equal to the mortality rate. Even though in recent years progress has been made in defining the morphological and key genetic changes, it is still unclear which factors trigger its occurrence. Some risk factors are age, gender and race, genetic susceptibility, dietary factors, fever, chronic pancreatitis, diabetes and physical inactivity. Studies have shown that an increase in BMI consequently leads to an increased risk of malignancies, including pancreatic cancer. Research based on adipokines and their role in obesity and the occurrence of pancreatic cancer are the potential for a possible future therapeutic interventions.

Cutaneous horn, a clinical manifestation of hyper-proliferation of compact keratin, can represent a wide array of underlying benign and malignant pathologies. Here we report a unique case of a giant cutaneous horn (7x4x3 cm) that developed on a chronic ulcer in a non sun-exposed area. This case presented challenges in terms of diagnosis and treatment. We also review the literature about this rare condition.

Telomere dysfunction is important in carcinogenesis, and recently, stathmin and elongation factor 1α (EF1α) were reported to be up-regulated in telomere dysfunctional mice. In the present study, the expression levels of stathmin and EF1α in relation to telomere length, telomere dysfunction-induced foci (TIF), γ-H2AX, and p21WAF1/CIP1 expression were assessed in specimens of hepatitis B virus (HBV)-related multistep hepatocarcinogenesis, including 13 liver cirrhosis specimens, 14 low-grade dysplastic nodules (DN), 17 high-grade DNs, and 14 hepatocellular carcinomas (HCC). Five normal liver specimens were used as controls. TIF were analyzed by telomere fluorescent in situ hybridization (FISH) combined with immunostaining, while the protein expressions of stathmin, EF1α, γ-H2AX, and p21WAF1/CIP1 were detected by immunohistochemistry. The expressions of stathmin and EF1α gradually increased as multistep hepatocarcinogenesis progressed, showing the highest levels in HCC. Stathmin mRNA le...

The objective was to describe the prevalence and factors associated with uterine cervical cancer (CA) and high-grade squamous intraepithelial lesions (HSIL) in adolescents. A cross-sectional study was carried out with 702 sexually active adolescents treated at a general hospital in Rio de Janeiro, Brazil, from 1993 to 2002. Screening was performed by cytopathology and colposcopy and confirmation by biopsy. Exposure variables were socio-demographic characteristics and those related to reproductive health, habits, and sexual behavior. Adjusted odds ratios were estimated using multivariate logistic regression analysis. Based on histopathology, the prevalence of HSIL/CA was 3% (95%CI: 1.8-4.6). There was one case of invasive cancer. With each additional pregnancy, the odds of HSIL/CA increased by 2.2 (95%CI: 1.1-4.4). Age was also associated with this outcome, doubling the odds of acquiring this degree of disease with each year of age (OR = 2.0; 95%CI: 1.2-3.4). The prevalence of lesion...

Population-based eradication of Helicobacter pylori has been suggested to be cost-effective and is recommended by international guidelines. However, the potential adverse effects of widespread antibiotic use that this would entail have not been sufficiently studied. An alternative way to decrease gastric cancer mortality is by non-invasive search for precancerous lesions, in particular gastric atrophy; pepsinogen tests are the best currently available alternative. The primary objective of GISTAR is to determine whether H pylori eradication combined with pepsinogen testing reduces mortality from gastric cancer among 40-64-year-old individuals. The secondary objectives include evaluation of H pylori eradication effectiveness in gastric cancer prevention in patients with precancerous lesions and evaluation of the potential adverse events, including effects on microbiome. Individuals are recruited from general population (50% men) in areas with high gastric cancer risk in Europe and und...

Aberrant crypt foci (ACF) are the earliest visible neoplastic lesions in the colorectum. The natural history of these lesions and their role in the adenoma-carcinoma sequence are unknown. We studied ACF in a subset of patients randomized to placebo (n = 17), celecoxib (200 mg twice daily; n = 15), or celecoxib (400 mg twice daily; n = 13) in the Adenoma Prevention with Celecoxib (APC) trial. Magnification chromoendoscopy was done to identify, count, and biopsy ACF within the rectum at baseline and after 8 to 12 months of treatment. A total of 655 ACF were identified in 45 patients. We examined 70 of these ACF histologically, and all 70 were nondysplastic. Cohort characteristics and APC trial treatment results for substudy patients were similar to those of the overall APC trial. There was no significant modulation of ACF by celecoxib (versus placebo; P = 0.77). Immunohistochemical comparison of ACF with adjacent normal mucosa showed that ACF had an increased proliferative index as de...

Introduction: OSMF is a potentially malignant disorder predominant in people of Asian descent. Copper plays important role in pathogenesis of OSMF. Lysyl oxidase is a copper activated enzyme critical for collagen cross linking. The uptake of copper into the epithelial cells occurs probably by a non-energy dependent diffusion. In Indians, the practice of drinking water stored in copper vessels for health benefits is being followed since ages. Aims and Objective: The present study was conducted to study the effect of consuming water stored in copper vessels in predisposing an individual to OSMF by evaluating cytological

Objectives/Hypothesis:A newly developed microscope‐based spectral‐domain optical coherence tomography (SD‐OCT) device and an endoscope‐based time‐domain OCT (TD‐OCT) were used to assess the inter‐rater reliability, sensitivity, specificity, and accuracy of benign and dysplastic laryngeal epithelial lesions.Study Design:Prospective study.Methods:OCT during microlaryngoscopy was done on 35 patients with an endoscope‐based TD‐OCT, and on 26 patients by an SD‐OCT system integrated into an operating microscope. Biopsies were taken from microscopically suspicious lesions allowing comparative study of OCT images and histology.Results:Thickness of the epithelium was seen to be the main criterion for degree of dysplasia. The inter‐rater reliability for two observers was found to be kappa = 0.74 (P <.001) for OCT. OCT provided test outcomes for differentiation between benign laryngeal lesions and dysplasia/CIS with sensitivity of 88%, specificity of 89%, PPV of 85%, NPV of 91%, and predict...

There is evidence that the risk of colon cancer is reduced by appropriate levels of physical exercise. However, the effects of single weekly bout of exercise are largely unknown. Our aim was to verify the effects of exercise once a week (1d-wk-1) and daily exercise training (5d-wk-...

Nephrogenic metaplasia or nephrogenic adenoma of the urinary tract may present a diagnostic challenge in surgical pathology practice. Previous case reports suggest the possibility of nephrogenic metaplasia progressing to clear cell adenocarcinoma, but a malignant potential of nephrogenic metaplasia is generally not acknowledged. A case of a 70-year-old female patient with multiple recurrences of nephrogenic metaplasia of the urinary bladder and subsequent development of clear cell adenocarcinoma is described. Immunohistochemical studies help to differentiate the 2 entities. Results of molecular studies, particularly comparative genomic hybridization analysis, suggest clonal evolution of nephrogenic metaplasia to clear cell adenocarcinoma in this case.

Sessile serrated adenomas/polyps (SSA/Ps) are considered to be precursors of colorectal cancers. They therefore need to be distinguished from hyperplastic polyps, and should be treated similarly to adenomas. Various endoscopic classifications for discriminating SSA/Ps have recently been proposed and validated, including the "Type II-O" pit pattern in magnifying chromoendoscopy and the "varicose microvascular vessel" in narrow-band imaging. However, there is currently no diagnostic consensus on the endoscopic appearance of SSA/Ps. Endocytoscopy (EC) is an emerging modality with diagnostic potential for SSA/Ps. EC is a type of a contact light microscopy, which allows the in vivo visualization of cells and nuclei facilitating precise, real-time pathological prediction. SSA/Ps show oval gland lumens with small round nuclei in EC, indirectly reflecting the pathological features. EC has shown a sensitivity of 83.3% and specificity of 97.8% for the diagnosis of SSA/Ps. ...

Aim: To evaluate the periodontal-status of patients with Pre-Cancerous
Condition and Pre-Cancerous lesions and compare it to that of healthy
control and to compare and correlate the periodontal status of patients with
Pre-cancerous condition & Pre-cancerous lesions& healthy adult patients
based on age, gender & deleterious habits.
Methods: A case-control study was conducted to assess Periodontal-health
Status among adults affected with Precancerous conditions & lesions in
Hyderabad-city. Study participants were Adults aged 35 years and above
with pre-cancerous conditions & lesions. The control group was also
matches with the age & gender with case-group.The Periodontal-status
was assessed by Bleeding on Probing (BOP), periodontal pockets, Loss of
Attachment (LOA) using World Health Organization (WHO)-Oral Health
Assessment-form for adults-2013.

Introduction: Head and neck cancer (HNC) refers to a wide range of
cancer types that develop in various tissues and organs located in the head
and neck area. The main risk factor for HNC is tobacco use.
Objective: This study aims to find the role of tobacco consumption in
developing head and neck cancer gender-wise with previous studies.
Methods: This retrospective comparative study was conducted at the
Department of Otolaryngology-Head & Neck Surgery at Bangabandhu
Sheikh Mujib Medical University, Dhaka, Bangladesh from June 2023 to
May 2024. 110 patients with head and neck cancer who completed the
inclusion criteria were selected for this study. Demographic profile, sites
involved, histopathological pattern and stage of presentation of head and
neck carcinoma were studied

A precise subset of Human Papillomavirus (HPV) genotypes, called high-risk genotypes, has now been undeniably established as the cause of invasive cervical cancer. HPV16 and 18 account for 70% to 80% of cervical cancers. Present study was planned to detect and type the High risk HPV in cytologically abnormal women. 80 cervical brushings were collected and subjected for pap smear followed by Polymerase chain reaction and genotyping. 24(30%) cases came positive for high risk human papillomavirus. Pap abnormal cases, categorized as ASCUS, LSIL & HSIL were studied for presence of HR-HPV genotypes. 06, 27, 25, & 22 specimens were respectively in ASCUS, LSIL, HSIL & other cervical abnormalities categories out of which 01(0.16%), 07(25.9%), 12(48.0%), and 04(18.1%) were HR-HPV positive. Genotyping of HPV revealed that HPV type 16 with 10(41.6%) cases was the most prevalent type detected followed by HPV type 18 with 06(25.0%) cases and 03(12.5%), 03(12.5%) and 02(8.3%) cases respectively of...

Department of Veterinary Medicine, Veterinary College, Anand-388001, Gujrat, India. *Corresponding Author. e-mail:ankitprjpt1@gmail.com ABSTRACT: Pancreatic cancer is a malignant neoplasm originating from transformed cells arising in tissues forming the pancreas. The most common type of pancreatic cancer is adeno-carcinoma. The present experiment was carried out to study histopathological changes occur in pancreas in different groups of azaserine induced pancreatic cancer in Wistar rats with and without the treatment of aqueous and alcoholic extract of Phyllanthus amarus at different doses. Histopathological examination of pancreas of untreated group of rats showed hyperplasia of pancreatic duct, necrosis, fatty changes, haemorrhages between pancreatic cells. The rats treated with Phyllanthus amarus extracts showed no pathological lesions.