RESUMO
Ovarian squamous cell carcinoma is a rare and aggressive ovarian neoplasm, where most of the cases arise from mature teratoma, which represents up to 20% of all ovarian tumors. Moreover, primary squamous cell carcinoma is considered to be related to human papillomavirus infection. The diagnosis is difficult and metastasis from bladder, genital tract, lung, and digestive tract cancers must be ruled out. There are no guidelines for treatment, however, radical surgery combined with adjuvant chemotherapy and radiation therapy, are the most common approach. We present the case of a young women diagnosed with a de novo ovarian squamous cell carcinoma, as well as the treatment and follow-up that she received.
Assuntos
Carcinoma de Células Escamosas , Neoplasias Ovarianas , Teratoma , Carcinoma Epitelial do Ovário/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/terapia , Quimioterapia Adjuvante , Feminino , Humanos , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/terapia , Teratoma/patologiaRESUMO
BACKGROUND: This exploratory analysis was conducted to characterize the level of HPV types 6/11 antibodies in peripartum maternal blood and in cord blood of infants born to women who received 9-valent HPV (9vHPV) vaccine or quadrivalent HPV (qHPV) vaccine in a pivotal efficacy study (V503-001, NCT 00543543). METHODS: A total of 21 mother-infant pairs had evaluable HPV 6/11 results available for analysis. HPV6/11 antibodies were assessed using competitive Luminex immunoassay. The distribution of the ratios of infant to mother anti-HPV antibodies (i.e., infant-anti-HPV/mother- anti-HPV) was summarized. RESULTS: All mothers and infants were seropositive to HPV 6 and HPV 11. Anti-HPV 6/11 geometric mean titers (GMTs) in peripartum maternal blood and in cord blood of infant born to study participants were highly correlated. A 100% of infants born to seropositive mothers were also seropositive. The GMT ratios of peripartum maternal blood vs. those in cord blood were HPV 6: 1.23 [0.43, 3.49] and HPV 11: 1.29 [0.54, 3.07] in the 9vHPV vaccine group and HPV 6: 1.33 [0.41, 4.29] and HPV 11: 1.19 [0.45, 3.13] in the qHPV vaccine group, respectively. CONCLUSIONS: These results indicate that antibodies induced by the 9vHPV vaccine cross the placenta, which could potentially be beneficial against HPV6/11 infection and related disease such as recurrent respiratory papillomatosis.
Assuntos
Anticorpos Anti-Hepatite/sangue , Papillomavirus Humano 11/imunologia , Papillomavirus Humano 6/imunologia , Imunidade Materno-Adquirida , Vacinas contra Papillomavirus/imunologia , Adolescente , Adulto , Método Duplo-Cego , Feminino , Sangue Fetal/imunologia , Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18/administração & dosagem , Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18/imunologia , Humanos , Imunogenicidade da Vacina , Lactente , Mães , Vacinas contra Papillomavirus/administração & dosagem , Gravidez , Adulto JovemRESUMO
Infection with the human papillomavirus (HPV) is responsible for 99.7% of cervical cancers, the second most prevalent neoplasia in women worldwide and the fifth leading cause of death by cancer in this population. In Chile, the incidence rate is 14.4 cases per 100,000 women per year and it is considered a significant public health problem. The natural history of cervical cancer begins gradually from low-grade and high-grade squamous intraepithelial lesions to an invasive disease. In this study the frequency of HPV types was determined by HPV genotyping with reverse line blot hybridization in 200 cytobrushes of women with preneoplastic lesions in a high-risk population. HPV DNA was found in 89% of the lesions (83.3% of low-grade squamous intraepithelial lesions and 93.6% of high-grade squamous intraepithelial lesions). Multiple HPV infections were found in 14.4% and 15.5% of low- and high-grade lesions, respectively. HPV 16 was the most frequent genotype in single infections, followed by HPV 18. These results show that most of the preneoplastic lesions of the cervix (60%) were associated with HPV 16 and/or HPV 18, supporting the implementation of an HPV vaccination program in this high-risk population.
Assuntos
Papillomaviridae/classificação , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Displasia do Colo do Útero/complicações , Displasia do Colo do Útero/virologia , Adolescente , Adulto , Idoso , Chile/epidemiologia , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Tipagem Molecular , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , Prevalência , Adulto JovemRESUMO
OBJECTIVE: To determine the prevalence rates of the different HPV types in cervical cancer lesions in Chile to facilitate the development of prophylactic human papillomavirus (HPV) vaccines effective for that country. METHOD: Biopsy samples of 312 cervical cancer lesions were assessed for HPV type by reverse-line blotting assay. RESULTS: HPV DNA was found in 94.2% of the lesions, 67.2% harboring 1 viral type and the remainder harboring more than 1 type. HPV-16 was the most frequent type in single infections (50.5%), followed by HPV-18 (7.8%), HPV-31 (2.4%), and HPV-45 (2.0%). HPV-16 was also present in 98.7% of dual and multiple infections, its most frequent association being with HPV-18. CONCLUSIONS: HPV types 16, 18, 31, and 45, alone or combined with other types, were observed in the biopsy samples of up to 80.5% of cervical cancer lesions.
Assuntos
Adenocarcinoma/virologia , Carcinoma de Células Escamosas/virologia , Papillomavirus Humano 16/isolamento & purificação , Papillomavirus Humano 18/isolamento & purificação , Infecções por Papillomavirus/virologia , Neoplasias do Colo do Útero/virologia , Adenocarcinoma/epidemiologia , Adulto , Carcinoma de Células Escamosas/epidemiologia , Chile/epidemiologia , DNA Viral/análise , Feminino , Genótipo , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Prevalência , Neoplasias do Colo do Útero/epidemiologia , Adulto JovemRESUMO
Mathematical models provide valuable insights into the public health and economic impact of cervical cancer vaccination programmes. An in-depth economic analysis should explore the effects of different vaccine-related factors and vaccination scenarios (independent of screening practices) on health benefits and costs. In this analysis, a Markov cohort model was used to explore the impact of vaccine characteristics (e.g. cross-type protection and waning of immunity) and different vaccination scenarios (e.g. age at vaccination and multiple cohort strategies) on the cost-effectiveness results of cervical cancer vaccination programmes. The analysis was applied across different regions in the world (Chile, Finland, Ireland, Poland and Taiwan) to describe the influence of location-specific conditions. The results indicate that in all the different settings cervical cancer vaccination becomes more cost-effective with broader and sustained vaccine protection, with vaccination at younger ages, and with the inclusion of several cohorts. When other factors were varied, the cost-effectiveness of vaccination was most negatively impacted by increasing the discount rate applied to costs and health effects.
Assuntos
Modelos Econométricos , Programas Nacionais de Saúde/economia , Neoplasias do Colo do Útero/economia , Neoplasias do Colo do Útero/prevenção & controle , Estudos de Coortes , Custos e Análise de Custo , Feminino , HumanosAssuntos
Prevenção Primária/organização & administração , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Saúde da Mulher , Adolescente , Adulto , Idoso , Chile/epidemiologia , Feminino , Humanos , Incidência , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Programas Nacionais de Saúde/organização & administração , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Classe Social , Esfregaço Vaginal/estatística & dados numéricos , Serviços de Saúde da Mulher/organização & administraçãoRESUMO
PURPOSE: To reexamine the use of adjuvant radiotherapy in optimally debulked patients. METHODS AND MATERIALS: Between January 1985 and April 1998, 60 patients were treated with adjuvant whole abdominal radiotherapy (A-WART). The stage distribution was Stage IC in 17 patients, Stage II in 9, and Stage III in 34. The grade distribution was Grade 1 in 9 patients, Grade 2 in 27, and Grade 3 in 24; thus, 60% of the patients had Stage III disease and 40% had Grade 3 tumors. After surgery, no residuum was left in 42 (70%),
Assuntos
Neoplasias Ovarianas/radioterapia , Abdome , Adolescente , Adulto , Idoso , Diarreia/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/cirurgia , Dosagem Radioterapêutica , Radioterapia Adjuvante/métodos , Cirurgia de Second-Look , Taxa de SobrevidaRESUMO
Desde comienzos de este siglo hasta mediados de la década del 50 la evolución de la superviviencia de cáncer endometrial ha sido modificada únicamente por el advenimiento de nuevos avances en técnicas anestésicas, mejor manejo para la enfermedad asociada, cirugía más acuciosa, con mayor rango de operabilidad y con el desarrollo de máquinas de alto voltaje (Cobalto 60, aceleradores lineales). Desde la década del 60 hasta comienzos del 80, si bien se incrementó la supervivencia libre de enfermedad a cinco años por el conocimiento de factores de riesgo asociados, ésta no ha sufrido mayor variación, independiente de las metodologías de tratamientos protocolizados en distintos centros. En la década actual, estudios recientes muestran la importancia de la citología peritoneal, diseminación microscópica en anexos e intra-abdominal, que va a incidir en un manejo más adecuado de la enfermedad pelviana y abdominal, que podría permitir una mayor supervivencia, que ha sido modificada en las dos últimas décadas
Assuntos
Humanos , Feminino , Neoplasias Uterinas/terapia , Endométrio/patologia , Neoplasias Uterinas/mortalidade , Neoplasias Uterinas/radioterapia , Neoplasias Uterinas/cirurgiaRESUMO
Se revisan los datos clínicos e histopatológicos de 10.558 pacientes hospitalizadas e intervenidas en la división de Ginecología Servicio de Obstetricia, Ginecología y Neonatología Hospital Paula Jaraquemada en el período 1975-1984; de ellas se estudian 510 pacientes en las cuales el diagnóstico histopatológico correspondió a una tumoración ovárica. Se exponen los conceptos básicos para decidir conducta ante un tumor ovárico. En el grupo de estudio se analizan: histología de los distintos tumores, frecuencia relativa de cada variedad histopatológica y edad de la paciente
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Neoplasias Ovarianas/classificação , Análise FatorialRESUMO
Se presentan 22 pacientes portadoras de Ca. vaginal primario invasor tratadas en el período comprendido entre 1977 - 1983, mediante Radioterapia externa y/o intracavitaria, intersticial o cirugía; correspondiendo a: Estadío I = 13 pacientes; Estadío II = 5 pacientes; Estadío III = 3 pacientes y Estadío IV = 1 paciente. (Tabla 1). Con un seguimiento mínimo de 18 meses, la sobrevida sin evidencia de enfermedad del grupo total es de 66% con un control local del 73% (curvas actuariuales a 8 años, "Berkson Gage")