Objective
A major controversy in sentinel node (SN) biopsy of endometrial cancer is the injection site of mapping material. We compared lymphatic drainage pathways of the uterine cervix and uterine body in the same patients by head-to-head comparison of intracervical radiotracer and fundal blue dye injections.
Methods
All patients with pathologically proven endometrial cancer were included. Each patient received 2 intracervical injections of 99mTc-phytate. At the time of laparotomy, the uterus was exposed, and each patient was injected with 2 aliquots of patent blue V (2 mL each) in the subserosal fundal midline locations. The anatomical locations of all hot, blue, or hot/blue SNs were recorded.
Results
Overall, 45 patients entered the study. At least 1 SN could be identified in 75 of 90 hemipelves (83.3% overall detection rate, 82.2% for radiotracer [intracervical] alone, and 81.1% for blue dye [fundal] alone). In 71 hemipelves, SNs were identified with both blue dye (fundal) and radiotracer (intracervical) injections. In 69 of these 71 hemipelves, at least 1 blue/hot SN could be identified (97.18% concordance rate). In 10 patients, para-aortic SNs were identified. All of these nodes were identified by fundal blue dye injection, and only 2 were hot.
Conclusions
Our study shows that lymphatic drainage to the pelvic area from the uterine corpus matches the lymphatic pathways from the cervix, and both intracervical and fundal injections of SN mapping materials go to the same pelvic SNs.
HTLV-1 (human T-lymphotropic virus type 1) causes chronic infection of human T lymphocytes. HTLV-1 infection is known to be related to multiple diseases, including neoplastic growth of HTLV-1-infected T cells (ATL) and neoplastic inflammatory conditions, such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), Sjögren’s syndrome with arthritis, polymyositis uveitis, and bronchoalveolitis. Regulatory T cells (Tregs) regulate inflammatory cells, such as Th17 cells. The purpose of this study was to evaluate Tregs and Th17 cells, as well as the expression of related transcription factors (ROR-?t and FOXP3) and cytokines (IL-10, TGF-?, IL-6, and IL-17A) in HTLV-1 infection.
Background: Cervical cancer is a preventable cancer with various risk factors. In this study, we assessed different risk factors involved in invasive cervical cancer in the Northeast of Iran.
Methods: In a case-control study, 99 patients with advanced cervical cancer were compared to 102 healthy, normal women. Cervical cancer risk factors were documented for these groups using a questionnaire and available medical notes. Univariate analysis was done for each risk factor, followed by multivariate regression analysis, to evaluate the most powerful risk factors after adjustment.
Results: Multivariate model indicated that sexual transmitted diseases (STD) [p<0.001; OR=7.88, 95% CI (2.59-23.93)], age at first intercourse ≤16 [p=0.048; OR=6.22, 95% CI (1.06-36.51)] and age [p=0.001; OR= 1.11, 95% CI (1.04-1.18)] were independently significant risk factors for cervical cancer.
Conclusion: According to this survey, the significant influence of major risk factors, including STD, age at first intercourse, and age itself, has been underlined. Moreover, increasing the social knowledge and educating people to prevent highrisk sexual behaviors, HPV testing, and routine use of HPV vaccine, which is nowadays regarded as a preventive measure in cervical cancer, may also be needed to be implemented in our prevention program.
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