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DRCPG MCQs for Circuit A Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Stage la cervical carcinoma is defined as carcinoma confined to the cervix, micro-invasive with a depth of invasion of < 3 mm into the stroma. It is diagnosed and may be treated by cone biopsy as long as there is no lymphatic involvement. Invasive carcinoma may be asymptomatic.
The female reproductive system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
The vast majority of invasive tumours of the cervix are primary epithelial tumours (carcinomas). The mortality from invasive cervical carcinoma is falling in the UK and, in 2010, there were 936 deaths. Cervical carcinoma has traditionally been a disease of older women, but the age-specific incidence is rising in younger women. The reasons for this are unclear, although the increase in adenocarcinoma may be one part of the explanation. Although the incidence of invasive cervical carcinoma is falling in the UK, it is important to remember that there is marked geographical variation in the incidence of this tumour. Particularly in developing countries, cervical carcinoma is a leading cause of death in women and, in 2008, over 520,000 cases of cervical cancer were recorded worldwide. Epidemiological studies have identified several factors that are associated with an elevated risk of developing invasive cervical carcinoma. These include: Early age at first intercourseNumber of sexual partnersLow socioeconomic statusHPV infection
Cervical Neoplasia, Human Papilloma Virus and Psychoneuroimmunology
Published in Herman Friedman, Thomas W. Klein, Andrea L. Friedman, Psychoneuroimmunology, Stress, and Infection, 2020
Michael H. Antoni, Karl Goodkin
Other factors traditionally viewed as risk factors for cervical carcinoma include age at first coitus, age at first pregnancy, African American ethnicity, family history, low SES, years of education, number of sexual partners, number of pregnancies, incidence of STDs, non-barrier contraceptive methods, circumcision of partner, marital discord, divorce, bereavement, sexual hygiene, douching practices, poor nutrition, and Pap smear frequency.51–54 Exposure to concomitant, multiple co-factors of progression such as smoking and STDs other than HPV does account for a significant proportion of the variance of CIN progression over time. For instance, one study found that more smokers than non-smokers present with CIN, especially CIN III, controlling for the incidence of miscarriage or abortion, pregnancy, prevalence of genital warts, use of oral contraceptive or barrier methods, and cytomegalovirus seropositivity.53 Given the high prevalence of smoking, low SES, multiple partners, inadequate contraceptive methods, and STDs in African American women are critical to assess these variables as possible confounds in PNI research with this population. Other lifestyle factors that favor immunosuppression (i.e., sleep deprivation, alcohol and substance use, caffeine intake, inadequate nutritional status, lack of exercise) and use of prescribed medications that can adversely affect immune function55 or other processes more directly associated with carcinogenesis such as DNA repair ability56 may comprise the set of sufficient criteria that complete the formula.
Mechanistic analysis of endothelial lipase G promotion of the occurrence and development of cervical carcinoma by activating the phosphatidylinositol-4,5-bisphosphate 3-kinase/protein kinase B/mechanistic target of rapamycin kinase signalling pathway
Published in Journal of Obstetrics and Gynaecology, 2023
Jing Huang, Renci Liu, Yiwen Zhang, Xiujie Sheng
The International Agency for Research on Carcinoma (IARC) of the World Health Organisation released the latest data in 2020. The total number of new carcinomas in the world was about 19.29 million, and the number of cervical carcinomas was 600,000 cases, which accounted for 3.1% (2021). Cervical carcinoma has its unique biological characteristics, such as invasiveness and metastasis, abnormal cell differentiation, proliferation, and loss of growth control. It can be divided into three processes: Carcinogenesis, carcinoma promotion, and evolution. Cervical carcinoma might occur through a long multi-factor and multi-step process; therefore, earlier diagnosis and effective treatment strategies have become an urgent need to prolong the survival period of patients with cervical carcinoma and to improve their quality of life.
Metabolic parameters of [18F]FDG PET-CT before and after radiotherapy may predict survival and recurrence in cervical cancer
Published in Acta Oncologica, 2023
Maria Markus, Hanna Sartor, Maria Bjurberg, Elin Trägårdh
[18F]fluorodeoxyglucose (FDG) positron emission tomography integrated with computed tomography (PET-CT) is a nuclear medicine imaging modality widely used for diagnosis, clinical staging, and response evaluation in cervical cancer and other malignancies [4,5]. In clinical practice, the most frequently used parameter is the maximum standardised uptake value (SUVmax), a semi-quantitative parameter, extracted from a single “hottest” voxel, thus not reflecting the whole tumour metabolism. Volume-based PET parameters such as metabolic tumour volume (MTV) and total lesion glycolysis (TLG) are suggested to better represent the total tumour burden and have been proven superior to SUVmax as prognostic markers for overall survival (OS) in head-and-neck cancer [6], non-small cell lung carcinoma [7–10] and ovarian cancer [11] and shown promising results in several other malignancies [12–15]. Regarding cervical carcinoma, some studies exist that have addressed this issue. A recent meta-analysis concluded that a high pre-treatment SUVmax had a significant correlation with OS in patients with locally advanced cervical cancer, but due to limited data no conclusions could be drawn regarding the association between TLG and MTV and OS [16]. Another meta-analysis, however, found that volume-based pre-treatment PET-CT parameters were significant prognostic factors of OS [17]. One meta-analysis found that response evaluation using post-radiotherapy FDG-PET CT was a prognostic factor for overall survival and progression-free survival [18]. However, no analysis of different PET parameters was done.
The effect of adjuvant radiotherapy on oncological outcomes in patients with early-stage cervical carcinoma with only intermediate-risk factors: a propensity score matching analysis
Published in Journal of Obstetrics and Gynaecology, 2022
Osman Turkmen, Fatih Kilic, Abdurrahman Alp Tokalioglu, Caner Cakir, Dilek Yuksel, Cigdem Kilic, Nurettin Boran, Gunsu Kimyon Comert, Taner Turan
Cervical carcinoma is the fourth most common malignant tumour in women worldwide (Bray et al. 2018). It is clinically staged according to the FIGO (International Federation Gynaecology and Obstetrics) staging system (Pecorelli 2009). FIGO revised the clinical staging system in 2018 by adding the lymph node status and reassessment of tumour size (Bhatla et al. 2018). Cervical carcinoma can be treated by surgery or radiation. Radiotherapy with chemotherapy is the accepted treatment in locally advanced disease (stage IIB–IVA), and the primary definitive treatment in early-stage (stage IB1–IIA2) disease is radical hysterectomy. Additionally, primary chemoradiotherapy may also be offered as an alternative method for this patient group (Landoni et al. 1997; Rungruang et al. 2012; Chen et al. 2015).