Postirradiation dysplasia of uterine cervix and vagina: An analytical study of the cells

Patten, Stanley F.; Reagan, James W.; Obenauf, Miriam; Ballard, Lester A.

doi:10.1002/1097-0142(196302)16:2<173::aid-cncr2820160206>3.0.co;2-l

Cited by 30 publications

(9 citation statements)

References 13 publications

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“…Besides HPV, radiation could represent a co-factor in the development of these lesions. The fact that the literature data indicate an occurrence of vaginal dysplasia in 23% of women undergoing hysterectomy plus radiotherapy, compared with 2-3% of dysplasia occurring naturally [Patten et al, 1963;Wentz et al, 1970], may support the involvement of radiotherapy. In this regard, radiation may favor either de novo or recurrent HPV infection through immunosuppression or upregulation of the E6/E7 HPV oncoproteins [Slater et al, 1976;Schneider et al, 1983;Santin et al, 1998;Brown et al, 1999].…”

Section: Discussionmentioning

confidence: 93%

“…Patients suffering from advanced uterine carcinoma have a considerable risk of developing vaginal preneoplastic lesions months to years following treatment, normally consisting of hysterectomy plus radiotherapy. After radiation, about 20% of patients will experience vaginal dysplasia, eventually ending in overt neoplasm [Patten et al, 1963;Wentz and Reagan, 1970]. Post-surgical radiation treatment is thought to be closely related to the increased risk of vaginal dysplasia, while the role of human papillomavirus (HPV) infection, although considered [Fujimura etal., 1991;Sugase and Matzakura,1997], has not been assessed properly by a case-control study.…”

Section: Introductionmentioning

confidence: 99%

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Vaginal dysplastic lesions in women with hysterectomy and receiving radiotherapy are linked to high‐risk human papillomavirus

Barzon

Pizzighella²,

Corti

et al. 2002

Journal of Medical Virology

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Patients undergoing radiotherapy for advanced cervical and endometrial cancer bear a considerable risk of developing vaginal preneoplastic lesions. Radiotherapy itself has been considered to have a role in the pathogenesis of vaginal dysplasia, although human papillomavirus (HPV) involvement has also been suggested. A series of 88 patients who underwent hysterectomy and were irradiated for gynecological cancer, including 43 with postradiation vaginal dysplasia at colposcopy and 45 without vaginal lesions, were included in this study. Detection and genotyping of HPV DNA in vaginal scraping were carried out by a PCR-based method and compared with colposcopic and cytological findings and with other clinical and laboratory data. Forty-two (97.7%) colposcopy-positive subjects and 6 (13.3%) colposcopically-negative patients were PCR-positive for high-risk HPV DNA (P < 0.000001). Twenty-two out of the 43 patients with colposcopic lesions showed an abnormal Papanicolau (PAP) test. Cytologic examination was negative in all colposcopically negative women. Type 16 HPV DNA was more frequent in patients with high-grade squamous intraepithelial lesions and in patients treated with external radiotherapy, whereas other types of high-risk HPV were more common in patients with low-grade lesions and in those treated with brachytherapy. When considering colposcopy as the standard for diagnosing vaginal dysplasia, HPV DNA testing was more sensitive than the PAP test. However, the specificity of the PAP test was higher with no false-positive case. In conclusion, vaginal preneoplastic changes in women post-hysterectomy and receiving radiotherapy for cervical, endometrial, and vaginal cancer represent an HPV-related nosologic entity. Whereas colposcopic examination can detect these preneoplastic lesions, HPV genotyping is a sensitive, inexpensive, and noninvasive method that may complement colposcopy and the PAP test.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Vaginal dysplastic lesions in women with hysterectomy and receiving radiotherapy are linked to high‐risk human papillomavirus

Barzon

Pizzighella²,

Corti

et al. 2002

Journal of Medical Virology

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“…Based on similar reports, some clinicians recommend eliminating the CVC altogether in the surveillance of these patients . In our opinion, however, these results are biased since the studies were performed before the introduction of the Bethesda System which provides uniform criteria for the classification of radiotherapy‐induced CVC changes . We receive 2000 to 3000 CVCs per year from patients with CRT, and we are thus familiar with the unique diagnostic difficulties in such cases.…”

Section: Discussionmentioning

confidence: 99%

“…14 In our opinion, however, these results are biased since the studies were performed before the introduction of the Bethesda System 15 which provides uniform criteria for the classification of radiotherapy-induced CVC changes. 16,17 We receive 2000 to 3000…”

Section: Discussionmentioning

confidence: 99%

Cytomorphological features of high‐grade intraepithelial neoplasia/carcinoma of the cervix following chemoradiotherapy

Serrano-Arévalo

Flores-Hernández

Villegas‐González

et al. 2018

Diagnostic Cytopathology

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Background Cervicovaginal cytology as a follow‐up study in women with a history of a cervical carcinoma treated with chemo‐radiotherapy (CRT) plays an important role; however, the cytomorphological characteristics for the diagnosis of high‐grade squamous intraepithelial lesions (H‐SIL) in post‐CRT patients have not been established. The aim of the study is to find the cytomorphological characteristics that support the diagnosis of H‐SIL by conventional cytology in these patients. Materials and methods This is a cross‐sectional study from 2009 to 2015, which includes patients with a diagnosis of squamous cell carcinoma treated with CRT, who all have cervix cytology for follow‐up and a later biopsy. Results We identified 82 cases, where the most frequent clinical stage was IIA1 to IIB with 26 cases (61.9%), the most common symptom was transvaginal bleeding (64.29%). The cytological characteristics that were statistically associated with the presence of a positive biopsy were the presence of a hemorrhagic background (45.2% vs. 12.5%, P = .007), high cellularity (45.2% vs. 15%, P < .001), disposition in groups/sheets (69% vs. 22.5%, P < .001), postradiotherapy changes at the background of the smear (73.8 vs. 50%, P < .001) and an increased nuclear/cytoplasmic ratio (100% vs. 22.5%, P < .001). Conclusions In patients with CRT, the presence of specific features can help the diagnosis of H‐SIL with excellent diagnostic performance.

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“…The effect of radiation therapy upon exfoliated benign and malignant cells of the female genital tract had been well described [Graham, 1947;Kjellgren, 1958;Zimmer, 1959;Graham, 1963;Takahashi, 19711. During recent years the significance of subjective quantitation, the presence of dysplastic cells [Patten et al, 1963;Hall and Walton, 1968;Wentz and Reagan, 1970;Meyer and Okagaki, 19721 and persistence or reappearance of malignant cells [Koss, 1959;Burns and Brack, 1960;Covington, 1963;Marcia1 et al, 1968;Massabuchi et al, 1969;Jorge Campos, 1970;McLennan and McLennan, 19751 had been stressed with reference to prognosis of these patients.…”

Section: Introductionmentioning

confidence: 99%

Radiation changes in vaginal and cervical cytology in carcinoma of the cervix uteri

Gupta

Sanyal

1982

Journal of Surgical Oncology

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Radiation changes are observed in all postirradiated smears of squamous cell carcinoma of the cervix from 56 females, although to a variable degree. After 1 year the changes subside gradually. A high cornification index is a good guide for recurrence. The significance of dysplastic cells as premonition for recurrence is debatable. The presence of malignant cells at any stage was considered of grave significance, and indicates poor radiation response or recurrence.

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Postirradiation dysplasia of uterine cervix and vagina: An analytical study of the cells

Cited by 30 publications

References 13 publications

Vaginal dysplastic lesions in women with hysterectomy and receiving radiotherapy are linked to high‐risk human papillomavirus

Vaginal dysplastic lesions in women with hysterectomy and receiving radiotherapy are linked to high‐risk human papillomavirus

Cytomorphological features of high‐grade intraepithelial neoplasia/carcinoma of the cervix following chemoradiotherapy

Radiation changes in vaginal and cervical cytology in carcinoma of the cervix uteri

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