ABSTRACT: The optimal method for managing a patient diagnosed with atypical squamous cells of undetermined significance (ASCUS) has not yet been established. The interim guidelines published by the National Cancer Institute suggest that a patient should be referred for colposcopy after the second ASCUS diagnosis within 2 years.
To assess the significance of ASCUS in predicting the presence of underlying squamous intraepithelial lesion (SIL) of the uterine cervix.
Women undergoing colposcopy for ASCUS cytology at a teaching hospital in Tehran University, in the years 1998-2001, considered eligible to enter this retrospective study.
Of the 266 patients who underwent colposcopy, 28 (11%) had low-grade squamous intraepithelial lesion (LSIL), 16 (6.3%) had high-grade squamous intraepithelial lesion (HSIL) two (0.8%) had squamous cell carcinoma (SCC), and 48 (18.8%) had flat condyloma.
Atypical squamous cells of undetermined significance (ASCUS) on a cervical smear is a good marker for detecting underlying SIL and condyloma. Thus, immediate colposcopy and directed biopsy are appropriate follow-up procedures.
Australian and New Zealand Journal of Obstetrics and Gynaecology 01/2005; 44(6):514-6. · 1.24 Impact Factor
ABSTRACT: To compare, with a retrospective study, endocervical and metaplastic cell number to identify the cytology of squamous intraepithelial lesion (SIL) of the cervix.
Cytology files from March 2000 to March 2003 were reevaluated, and those with SIL were identified.
In 8,743 cervicovaginal smears were found 70 (0.8%) SIL smears (39 low grade, 31 high grade) and 140 randomly selected smears without squamous or glandular abnormalities that were not atrophic or unsatisfactory. Endocervical and metaplastic cells counted in these smears and then classified into 5 groups were compared with each other.
Women with smears containing endocervical cells are not at greater risk for SIL than those with smears lacking these cells. Women with smears containing metaplastic cells are more likely to have SIL than those without metaplastic cells. In addition, high grade lesions are more likely in smears containing more metaplastic cells.
Acta cytologica 50(2):178-80. · 0.49 Impact Factor
ABSTRACT: Tamoxifen is the drug of choice in the treatment of breast cancer. Recent reports show an increased incidence of endometrial carcinoma in patients taking tamoxifen. In this article, we report a case of malignant mixed mullerian tumor after tamoxifen use.
Iranian Journal of Pharmacology and Therapeutics (ISSN: 1735-2657) Vol 5 Num 1.
ABSTRACT: There are therapeutic dilemmas regarding fertility-preserving treatment among young women with well-differentiated endometrial carcinoma.
Twenty-one patients with stage IA well-differentiated endometrial adenocarcinoma were enrolled in a prospective study. The treatment initiated with 160 mg/d of megestrol acetate. The patients underwent dilatation and curettage and hysteroscopy after 3 months, and in cases of normal pathology, the therapy continued for another 3-month period. In patients who did not respond to treatment, the dosage of the drug was doubled (320 mg/d), and the therapy continued for another 3 months. At the second time, patients who did not respond to treatment were recommended for hysterectomy, and in patients who responded to treatment, an additional 3 months of treatment with megestrol acetate (320 mg/d) was administered.
Our results showed a response rate of 85.71% (18 patients), and 3 patients underwent hysterectomy. The mean (SD) treatment duration was 8.85 (2.00) months (range, 6-12 months). The response to therapy was observed in 5 patients (27.78%) with a dosage of 160 mg/d, and the remaining patients with 320 mg/d. Pregnancy occurred in 5 patients (27.78%). Recurrence happened in 3 (16.67%) of 18 patients who responded to treatment who did not give a permit to undergo hysterectomy and received medication again. Two (66.67%) of these patients experienced remission again, whereas the other one was candidate for hysterectomy.
The results of this study show that, when an initial response is not achieved or when disease recurs, use of 320 mg/d seems to be associated with a better therapeutic response. Furthermore, serious complications were not observed with this dosage.
International Journal of Gynecological Cancer 19(2):249-52. · 1.65 Impact Factor