OBJECTIVE: The aim of this study was to identify human papillomavirus (HPV) in cervical intraepithelial neoplasia (CIN) and to evaluate the persistence of HPV after loop electrosurgical excision precedure (LEEP). METHODS: Records of 138 patients with LEEP performed due to cervicitis, CIN I, CIN II and CIN III were reviewed and persistence of HPV were followed up at 3, 6, 9 and 12 month after LEEP treatment from January 1996 to December 1999. RESULTS: Among 202 patients, 138 cases (68.3%) were showed HPV positive before LEEP and histologic findings were showed as cervicitis 20 cases (14.5%), CIN I 23 cases (16.7%), CIN II 31 cases (22.5%) and CIN III 64 cases (46.3%). Persistence of HPV after LEEP treatment were 10.9% (15/138) at 3 month and 2.9% (4/138) at 6 month. However, among 15 cases of persistent HPV, only 5 cases (33.3%) were showed an abnormal Pap smear at 3 month after LEEP. CONCLUSION: Human papillomavirus (HPV) was eliminated over 90% at 3 month after LEEP treatment in CIN. Detection of HPV was helpful to estimate therapeutic effect and to predict the recurrence or persistence of CIN after LEEP treatment.
Cervical Intraepithelial Neoplasia* ; Humans ; Recurrence ; Uterine Cervicitis

This study evaluated the degree and the frequency of cervical lesions after treatment with LEEP(loop electrosurgical excision procedure) in patients with abnormal Pap smears according to the presence or absence of high-risk HPV infection. From June 1994 to May 1997, eighty patients who showed CIN or chronic cervicitis on LEEP specimens were followed up with Pap smears. The histologic results and follow-up Pap smear data were analyzed. In all cases HPV test by Hybrid Capture assay was performed. Those with neoplastic lesion underwent follow-up Pap smears at least for 1 year with 3 month interval after LEEP. In HPV-positive group(N 38), 63.2% of the cases revealed neoplastic lesion(CIN) on final histologic evaluation, and in HPV-negative group(N 42) 54.8% of the cases did(p 0.26). HPV-positive group represented 25.0%(6/24) of abnormal Pap smear result on follow-up, which is higher than that of HPV-negative group(4.3%; 1/23), showing significant difference (p<0.05). There was a significant difference in the rate of neoplastic lesion developed during follow-up between resection margin-positive group and resection margin-negative group on LEEP(p 0,04). Also, HPV-positive group had significantly higher chance to show abnormal Pap smear results during follow-up(p 0.02). In conclusion, HPV test and margin status were shown to be useful parameters to predict the recurrence or persistence of CIN lesion treated by LEEP.
Follow-Up Studies ; Humans ; Recurrence ; Uterine Cervicitis

OBJECTIVE: We tried to confirm the effects of green tea extracts (polyphenon E, EGCG) in patients with human papilloma virus (HPV) positive cervical lesion. METHODS: We divided 51 HPV positive cervical lesion patients (chronic cervicitis, mild dysplasia, moderate dysplasia and severe dysplasia) into 4 group and 37 patient as placebo control. We applied poly E ointment two times per week (27 patients), poly E ointment plus poly E capsule (8 patients), poly E capsule (6 patients), EGCG capsule (10 patients) 200 mg each for 8 to 12 weeks. RESULTS: Among 27 patients with poly E ointment group, 20 patients responded (74%), such as chronic cervicitis (12/18), mild dysplasia (4/5), moderate dysplasia (2/2) and severe dysplasia (1/2). Among 8 patients with poly E ointment and poly E capsule group, 6 patients responded (75%), 6 patients poly E capsule group responded 3 patients (50%). 10 EGCG capsule patients group responded 6 patients (60%). Overall responsive rate is 69% (35/51) in case of green tea extracted treated group and 10% (4/39) in placebo controlled group (P<0.05). CONCLUSION: The effects of green tea extract in HPV positive cervical lesion were statistically significant (P<0.05). This result suggests that green tea extract has highly potential of new treatment agent for HPV infected cervical lesion.
Humans* ; Papilloma* ; Tea* ; Uterine Cervical Neoplasms ; Uterine Cervicitis

OBJECTIVE: The aim of this study is to compare the clinician's attitude to the large loop excision of transformation zone (LLETZ) according to the subspecialty; gynecologic oncology or not. METHODS: Eighty-one patients who had LLETZ at Seoul National University Bundang Hospital from June 2003 to September 2004 were reviewed. The pathologic reports for LLETZ were compared with the results of punch biopsy according to the operator's subspecialty. RESULTS: Gynecologic oncologist had 38 patients (GO group) and non-gynecologic oncologist had 43 patients (NGO group). The age distribution was not different between two groups (40.3 +/- 8.3 in GO group, 42.4 +/- 9.4 in NGO group; p=0.301). The histopathology of punch biopsy and LLETZ correlated well each other in both groups (p=0.01 in both groups). In NGO group, 11 patients (25.6%) had chronic cervicitis or mild dysplasia on punch biopsy while only a patient (2.6%) had mild dysplasia on punch biopsy in GO group. CONCLUSION: This study shows that the non-gynecologic oncologist used LLETZ more frequently in the management of low-grade cervical intraepithelial neoplasia than gynecologic oncologist.
Age Distribution ; Biopsy ; Cervical Intraepithelial Neoplasia ; Humans ; Seoul ; Uterine Cervicitis

Multilocular cystic lesions in the uterine cervix can vary widely from benign to malignant. Pseudoneoplastic glandular lesions are benign lesions that are often histologically and radiographically confused with adenoma malignum, which is a rare variant of mucinous adenocarcinoma of the uterine cervix. The benign lesions include uterine cervicitis, tunnel cluster, deep endocervical glands, deep nabothian cysts, endocervical hyperplasia, infectious and reactive atypias. It is crucial but difficult to differentiate between an adenoma malignum and the benign cystic lesions. We report two cases of large nabothian cysts mimicking adenoma malignum. Radiologic findings, signs, and symptoms of these cases are described.
Adenocarcinoma, Mucinous ; Adenoma ; Cervix Uteri ; Female ; Hyperplasia ; Uterine Cervicitis

BACKGROUND: The grey zone of cervical cytology, and in particular atypical squamous cells, cannot exclude HSIL (ASC-H) causes diagnostic difficulties and increases medical expenses. We analyzed p16INK4a expression in ASC-H liquid-based cytology specimens (LBCS) to develop more effective methods for the management of ASC-H patients. METHODS: We carried out p16INK4a immunostaining with 57 LBCS of ASC-H diagnostic categories, all of which were histologically cofirmed and 43 cases of which were compared with the results of a human papillomavirus (HPV) chip test. RESULTS: p16INK4a immunostaining with ASC-H LBCS was positive in 20% (3/15) of cervicitis, 25.0% (3/12) of tissue-low-grade squamous intraepithelial lesion, 75.0% (18/24) of tissue-high grade squamous intraepithelial lesion (HSIL), and 100% (6/6) of invasive cancer cases. The positivity of p16INK4a in LBCS was correlated with higher grade of histologic diagnosis (r=0.578, p=0.000). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of p16INK4a immunostaining for the prediction of tissue-HSIL+ were 80.0%, 77.8%, 80.0%, and 77.8%, respectively. The sensitivity, specificity, PPV, and NPV of p16INK4a immunostaining plus HPV chip test for predicting tissue-HSIL+ were 71.2%, 86.4%, 84.2%, and 79.2%. CONCLUSIONS: p16INK4a immunostaining as well as HPV chip testing with remaining LBCS with ASC-H are useful objective markers for the prediction of tissue-HSIL+.
Cervical Intraepithelial Neoplasia ; DNA Probes ; Humans ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; Uterine Cervicitis

OBJECTIVE: To investigate the efficacy of the cervical cytology as a screening tools for cervical cancer and to roughly estimate the prevalence of cervical cancer and precancerous lesion in the general population by evaluating the cytologic results in the group of women visited our health care center. METHODS: Pap smear was used for cervical cancer screening and interpretated with The Bethesda system. Women who had abnormal Pap result were evaluated with Punch biopsy or cone biopsy at the outpatient unit if possible. RESULTS: For the past two years, Pap smear tests have been given to 4536 women without any symptoms in health care center, and the results are as follows: The average age was 47.9 +/- 11.8 years. Of the 4536 who were tested 4337 women (95.6%) showed normal cytology. 147 (3.2%)of the women showed ASCUS or AGUS; LGSIL and HGSIL each had 24 (0.5%) women. And 4 (0.1%) women showed malignant cells. 37 (59.7%) of the women who have been given punch biopsy showed chronic cervicitis and 16 (25.8%) of them had dysplasia and 7 (11.3%) had CIS and 2 (3.2%) had invasive cervical cancer. 6 of HGSIL cytology were found to be CIS, and 1 of women who had malignant cells was found to be CIS and 2 of them were found to be invasive cervical cancer. CONCLUSION: As the result, women without any previous symptoms showed signs of either: moderate dysplasia, severe dysplasia, CIS or invasive cervical cancer. Of the fourteen women who had severe dysplasia and CIS, nine (60.4%) were 4 th decade or less. Therefore, routine pap smear testing to younger aged women who have not had any symptoms should be recommended.
Biopsy ; Delivery of Health Care* ; Female ; Humans ; Mass Screening* ; Outpatients ; Prevalence ; Uterine Cervical Neoplasms ; Uterine Cervicitis

OBJECTIVE: To evaluate the significance of atypical squamous cells of undetermined significance(ASCUS) by following-up cervical cytologic smears or histologic finding. METHODS: Two hundred fifty three cases were diagnosed as ASCUS on cervical cytologic smears from January, 3, 1997 to september, 16, 1998 at cytopathology laboratory, College of Medicine, Keimyung Univemity. These cases were evaluated by cervical smears or subsequent biopsies. RESULTS: The results were as follows, On repeat cervical smears, inflammation was 19.7%, normal was 11,1% and HSIL was 1.6%. On histologic diagnosis, CIS was 13,4%, cervicitis was 12,6%, invasive cervical cancer was 4.0%, and severe dysplasia was 3.2%. CONCLUSION: A diagnosis of ASCUS on smears need careful follow-up.
Biopsy ; Diagnosis ; Follow-Up Studies ; Inflammation ; Uterine Cervical Neoplasms ; Uterine Cervicitis ; Vaginal Smears

BACKGROUND: Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screeningg test of cervical cancer. MATERIALS AND METHODS: Cervicography was taken from 482 women at department of obstetrics and gymecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999, of the 482 women, 172women were excluded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology(Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. RESULTS: The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chromic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05) The sensitivity of cytology and cervicography were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13.3%)(p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%)(p<0.05). CONCLUSION: It seems inappropriate to use cervicography as a single scerrning test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.
Biopsy ; Carcinoma in Situ ; Colposcopy ; Female ; Humans ; Korea ; Mass Screening* ; Metaplasia ; Obstetrics ; Uterine Cervical Neoplasms* ; Uterine Cervicitis

OBJECTIVETo evaluate the clinical value of domestically manufactured digital colposcope system (SLC-2000) in the detection of early cervical lesions.

METHODSDuring a follow-up study of patients in Xiangyuan county, Shanxi, a high risk area for cervical cancer, a digital colposcope and an optical colposcope were randomly used for diagnosis, with pathology as the gold standard.

RESULTSIn 163 cervical biopsy specimens, 103 were diagnosed as chronic inflammation by histologic examination. Among 60 specimens which gave abnormal pathology, there were papilloma 1, cervical intra-epithelial neoplasia (CIN) I 37, CIN II 18 and CIN III 4. In 33 endocervical curettage specimens, 3 were pathologically positive. Comparing the digital and optical colposcope in diagnosing the positive lesions of > or = CIN I, the sensitivity of the former and latter were 83.3% and 95.0%, the difference without being statistically significant (P = 0.075). The specificity, positive predictive value, and accuracy of these two instruments were 61.2%, 21.4%, 55.6% and 41.3%, 69.3% 48.5%, with significant difference (P = 0.000, P = 0.035, and P = 0.000). In diagnosing > or = CIN II cervical lesions, these three results of the two instruments did not show any significant difference either. The negative predictive value of the digital and optical colposcope were 86.3% and 88.0%, also showing no significant difference (P = 0.075).

CONCLUSIONThe specificity, positive predictive value, and accuracy of the digital colposcope in diagnosing cervical lesions > or = CIN I are all superior to those of the traditional optical colposcope, even though the sensitivity of the latter is higher. There is no difference between the two instruments in diagnosing lesions > or = CIN II. Not only is domestic digital colposcope (SLC-2000) effective, but feasible and practical in the diagnosis, research and follow-up of cervical lesions.

Colposcopes ; Female ; Humans ; Predictive Value of Tests ; Sensitivity and Specificity ; Uterine Cervical Diseases ; diagnosis ; Uterine Cervical Neoplasms ; diagnosis ; Uterine Cervicitis ; diagnosis