Gynecology Oncology
Haleh Ayatollahi; Samira Jahangard; Siamak Naji; Zahra Yekta
Volume 7, Issue 3 , January and February 2022, , Pages 206-212
Abstract
Background and Objective: Cervical cancer is a common neoplasm in women, and the role of the HPV virus in the development of precancerous and cancerous cells has been established. There exist different strains of the HPV virus with varied functions. In the high-risk HPV strains, the p16 and ki67 proteins ...
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Background and Objective: Cervical cancer is a common neoplasm in women, and the role of the HPV virus in the development of precancerous and cancerous cells has been established. There exist different strains of the HPV virus with varied functions. In the high-risk HPV strains, the p16 and ki67 proteins play a crucial role in regulating the cell cycle leading to cell proliferation and progression. P16 and ki67 proteins are positive in almost all lesions and indicate a high degree of malignancy. This study aims to investigate the predictive effect of p16 and ki67 on the progression of low-grade intraepithelial lesions to high-grade malignancy.Methods: P16 and ki67 were measured on CIN1 lesions, and during the average two-year follow-up period, the outcome of positive cases was investigated. A total of 106 referred patients between the age of 15 to 75 years were examined from April 2015 to March 2019.Results: Among the patients with progression of CIN1 to CIN2 and other severe lesions, p16 was positive in 14 cases (60.9%), and a significant difference between groups with positive and negative markers in the progression or regression of lesions was noticed. Ki67 frequently occurs in CIN2 and other severe lesions.Conclusion: The use of p16 and ki67 as predictive markers is still under debate. In countries like the United States, these are not yet used separately for prediction but are being used in combination together. The authors of this study strongly recommend the conduction of further studies to assess the role of p16 in association with other markers and within a larger population so as to apply the functional role of p16 and ki67 in the clinical setting thereby effectively preventing it.
Gynecology Oncology
Haleh Ayatollahi; Samira Jahangard
Volume 6, Issue 1 , January 2021, , Pages 35-41
Abstract
Background: Choriocarcinoma is the most aggressive kind of gestational trophoblastic neoplasia (GTN). Although the risk of brain metastasis in GTN is rare, in patients with choriocarcinoma, the incidence of brain metastasis is 11%. In this paper, we reported a case of choriocarcinoma with brain metastasis, ...
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Background: Choriocarcinoma is the most aggressive kind of gestational trophoblastic neoplasia (GTN). Although the risk of brain metastasis in GTN is rare, in patients with choriocarcinoma, the incidence of brain metastasis is 11%. In this paper, we reported a case of choriocarcinoma with brain metastasis, which was successfully treated with an etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMACO) regimen.Case presentation: A 34-year-old woman was presented with vaginal bleeding, dyspnea, and moderate abdominal pain. She had a menstrual delay of about two weeks. She had a primary β-human chorionic gonadotropin (β-hCG) of 132 600 mIU/mL. On lung computed tomography (CT) scan images, a metastatic lesion with a size of 68×50 mm was observed in the lower lobe of the left lung. The patient underwent dilation and curettage (D&C) that revealed choriocarcinoma. Brain magnetic resonance imaging (MRI) also showed a small metastatic mass with a size of 7 mm at the right occipital lobe. The patient was started on chemotherapy with an EMACO regimen. The patient’s β-hCG decreased continuously, and it was negative after the fourth cycle and six sessions of radiotherapy. It also remained negative six months after chemotherapy. The final examinations of the patient had no abnormal findings. Conclusion: Brain metastasis may be relatively asymptomatic in patients with choriocarcinoma, and it should be considered by physicians, even when there are no neurological symptoms. Also, the EMACO regimen seems to be an appropriate regimen for the treatment of metastatic choriocarcinoma.
