Gynecology Oncology
Azam-Sadat Mousavi; Setareh Akhavan; Fareideh Sabzi shahrbabaki; Narges Izadi-mood; Fariba Yarandi; Mehran Ghazimoghadam; Mohammad Pouryasin; Saina Nassiri; Mamak Shariat; Ali Pouryasin
Volume 7, Issue 3 , January and February 2022, , Pages 151-157
Abstract
Background & Objective: Recent advances in molecular testing for human papillomavirus (HPV) has increased the accuracy of cervical screening programs. This study intended to estimate the diagnostic value of high-risk (HR) HPV DNA- and E6/E7 mRNA-based methods for triage of Iranian women with ...
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Background & Objective: Recent advances in molecular testing for human papillomavirus (HPV) has increased the accuracy of cervical screening programs. This study intended to estimate the diagnostic value of high-risk (HR) HPV DNA- and E6/E7 mRNA-based methods for triage of Iranian women with abnormal cytological results regarding the histopathological cut-off.Materials & Methods: In this cross-sectional study, 360 non-pregnant women (≥ 21 years) who had faced abnormal cytological findings (ASC-US and LSIL) were enrolled and referred for further diagnostic tests. The INNO-LiPA® HPV Genotyping Extra-II and Aptima HPV assay kits were used in DNA- and E6/E7 mRNA-based methods for detection of HR-HPV. Regarding the CIN-2+ histopathological cut-off, the diagnostic value of each molecular-based assay was calculated.Results: Among the study participants, 260 cases had ASC-US, and 100 had LSIL. The overall positivity rate for DNA- and mRNA-based methods was 74.4% (268/360) and 64.2% (231/360), respectively. Fifty-nine (16.4%) individuals showed CIN-2+. The DNA-based test showed higher sensitivity (100%) than the mRNA-based method (93.2%), while the mRNA-based method revealed greater clinical specificity (41.5%) compared to the DNA-based test (30.6%).Conclusion: Our results revealed appropriate clinical sensitivity of the molecular-based methods for triage of Iranian women with abnormal cytological results; however, the mRNA-based method showed greater specificity for detection of CIN-2+.
Obstetrics and Gynecology
Fatemeh Golshahi; Fariba Yarandi; Sara Ramhormozian; Elham Shirali
Volume 7, Issue 2 , September and October 2021, , Pages 121-125
Abstract
With increase in the second-trimester pregnancy termination, debates continue on the most suitable mode of termination. Misoprostol is used as an agent for the medical abortion. Some authors believe that uterine rupture risk as a complication of medical termination is higher in the patients with positive ...
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With increase in the second-trimester pregnancy termination, debates continue on the most suitable mode of termination. Misoprostol is used as an agent for the medical abortion. Some authors believe that uterine rupture risk as a complication of medical termination is higher in the patients with positive cesarean section history while some others have no report of such effect. This complication cannot be predicted and can occur under various circumstances with different misoprostol regimens. Hereby, we reported three cases with positive cesarean section history undergoing second-trimester pregnancy termination due to preterm premature rupture of the membranes (PPROM) who developed uterine rupture with similar misoprostol dosages. Finally, we conclude that more cautions should be undertaken in the setting of PPROM with previous history of cesarean section or gestational age >20 weeks about uterine rupture risk and full recommended misoprostol dose must not be administered to prevent life-threatening events.
Elham Shirali; Fariba Yarandi; Mostafa Safavi; Omid Hemmatian; Marjan Ghaemi
Volume 4, Issue 3 , September and October 2019, , Pages 117-119
Abstract
Background & Objective: Primary vaginal sarcomas are extremely rare and counts about 2-3% of all vaginal malignancies. We report a case with vaginal leiomyosarcoma which was treated by radical hysterectomy.
Case Report: A 46 year old woman from Iraq, referred to Yas Hospital by chief complaint of ...
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Background & Objective: Primary vaginal sarcomas are extremely rare and counts about 2-3% of all vaginal malignancies. We report a case with vaginal leiomyosarcoma which was treated by radical hysterectomy.
Case Report: A 46 year old woman from Iraq, referred to Yas Hospital by chief complaint of post-coital bleeding and a vaginal mass with pathology report of vaginal leiomyosarcoma. She underwent radical hysterectomy with bilateral salpingo-oophorectomy and partial vaginectomy (2/3 upper of the vagina). She refused to receive chemotherapy after surgery. In 3 years follow up, she did not have any recurrence.
Conclusion: Experiences about vaginal leiomyosarcoma are not sufficient due to rarity of the disease. However, based on review of the literature surgery is still the first choice followed by both chemotherapy and radiotherapy that are preferred based on current reports.
Elham Shirali; Fariba Yarandi; Nadereh Behtash; Omid Hemmatian
Volume 3, Issue 2 , May and June 2018, , Pages 87-91
Abstract
Aims: Cervical cancer is one of the most common cancer in the female since 1990. Neoadjuvant chemotherapy (NACT) uses before surgery, especially in countries with limited radiotherapy facilities. The aim of the present review was to study the effect of NACT before radical surgery in comparison with other ...
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Aims: Cervical cancer is one of the most common cancer in the female since 1990. Neoadjuvant chemotherapy (NACT) uses before surgery, especially in countries with limited radiotherapy facilities. The aim of the present review was to study the effect of NACT before radical surgery in comparison with other treatments and various clinical outcomes.
Information and Methods: This study is a systematic review and includes previous publishes about cervical cancer and effect of NACT before radical surgery. Over 40 previous studies were reviewed, none of them was case report, at least 5 studies were randomized clinical trials and 6 of them were meta-analysis or systematic review.
Findings: NACT before surgery demonstrates advantages to reduce the rate of lymph node metastasis and parametrial infiltration, so improves progression-free survival in patients with pelvic lymph node invasion (Approximately 35% of stage IB2–IIB bulky). NACT also decreases tumor volume and minimizes the need for adjuvant radiotherapy, thus NACT under consideration of quality of life and cost-effectiveness should be recommended. NACT is really effective in decreasing incidence of pathological risk factors.
Conclusion: NACT response associated with the stage of diagnosis, tumor size and pathology of the specimen (Squamous tumor has a better response than a non-squamous tumor). NACT seems to be feasible in the management of stage IB bulky cervical cancer, NACT followed by surgery represent an alternative to primary chemoradiotherapy in young and sexually active patients.
Soheila Aminimoghaddam; Ghazal Kamyabi; Fariba Yarandi; Soghra Zarei
Volume 2, Issue 2 , May and June 2017
Abstract
Background: Endometrial carcinoma is the most common cancer of the female genitalia and its prevalence is 2% to 3% along the females’ lifetime. This adenocarcinoma is diagnosed in the early stages because the patients become symptomatic early in the course of disease. The correlation of the lower ...
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Background: Endometrial carcinoma is the most common cancer of the female genitalia and its prevalence is 2% to 3% along the females’ lifetime. This adenocarcinoma is diagnosed in the early stages because the patients become symptomatic early in the course of disease. The correlation of the lower uterine segment involvement (LUSI) with the recurrence, and the survival rates in patients with endometrial adenocarcinoma are always questionable. Confirming the prognostic significance of LUSI can fundamentally improve the current state of patients’ surveillance. The current study aimed at investigating the association of lower uterine segment involvement with deep myometrial invasion in endometrial adenocarcinoma.
Methods: In the current retrospective cohort study, 54 patients with stage I endometrial endometrioid adenocarcinoma who underwent surgery in Mirza-Koochak-Khan Hospital, Tehran, Iran, from 2004 to 2014 were divided into 2 groups according to the presence of LUSI. In the current cohort study, the data from the patients exposed to LUSI were obtained by questionnaires to measure deep myometrial invasion besides post-operative adjuvant radiotherapy. The median of follow-up period was 48 months for all of the patients, which started after their surgery, and the measurement period for variables were similar to those of the follow-up period, which was 48 months. They were compared regarding to age, tumor grade, depth of myometrial invasion, lymphovascular involvement, extra uterine diseases, the extent of lymphadenectomy, adjuvant therapy, recurrence rate, time, and location. The data analysis was conducted by the SPSS v.16 statistical software (Chicago, IL, USA) at the significance level of 5%. In the investigation, Chi-square, the Kolmogorov-Smirnov, t test, and the Mann-Whitney U tests were used.
Results: Group 1 consisted of 13 patients with LUSI and group 2 had 41 patients without LUSI divided by a non-random sampling method. According to the results of the Mann-Whitney U test, there was a significant difference between the mean age of patients with LUSI and that of the ones without LUSI (P = 0.03). It showed that the mean age in the former group was significantly higher than that of the latter. A Chi-square test showed no significant association between the lymphovascular involvement and the presence of LUSI (P = 0.1). The Fisher exact test showed that patients with LUSI had significantly higher rate of radiotherapy after surgery rather than the ones without LUSI (P < 0.001).
Conclusions: In conclusion, there was a significant association between the lower uterine segment involvements with deep my ometrial invasion in the endometrial endometrioid adenocarcinoma. In other words, there was a significant difference in the depth of myometrial invasion between the groups, and the patients with LUSI had deeper myometrial invasion (the Mann-Whitney U test, P < 0.001).
Elham Shirali; Fariba Yarandi; Majid Safavi; Omid Hemmatian
Volume 1, Issue 1 , May and June 2016
Abstract
Introduction: Early diagnosis of endometrial cancer in younger female patients has good prognosis and better survival because of lower stage and lower grade. Endometrial cancer should be diagnosed early at lower stage because of signs and symptoms of patients. We report on a usual case of endometrial ...
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Introduction: Early diagnosis of endometrial cancer in younger female patients has good prognosis and better survival because of lower stage and lower grade. Endometrial cancer should be diagnosed early at lower stage because of signs and symptoms of patients. We report on a usual case of endometrial cancer that was miss diagnosed because she insisted on the protection of her hymen and virginity.
Case Presentation: We report a usual case of endometrial cancer that was miss-diagnosed because the patient insisted on the protection of her hymen and virginity. A 32-year-old virgin female did not permit a general gynecologist for endometrial biopsy or curettage, to protect her hymen and virginity; the patient had stage IV endometrial cancer.
Conclusions: In conclusion, patients with persistent signs and symptoms should be considered for endometrial cancer especially patients with high risk factors: nulliparity, late menopause, obesity, diabetes mellitus, unopposed estrogen therapy, tamoxifen therapy, atypical endometrial hyperplasia, Lynch II syndrome, etc. However, the most important issue for patients with persistent symptoms and risk factors for endometrial cancer in highly religious countries is obtaining a document for the gynecologist that endorses patient virginity.
