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Assessment of the validity of Pap smear cytology in the diagnosis of cervical intraepithelial neoplasia in Erbil city
تقييم صحة خلايا تشريح عنق الرحم في تشخيص الأورام داخل عنق الرحم في مدينة أربيل

Author: Baran Kamal Barzanji
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2011 Volume: 15 Issue: 3 Pages: 64-69
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objectives: Cervical smears can reduce both incidence and mortality rates from invasive cervical cancer. Despite its success, cervical cytology has important limitations. The aim of this study is to assess the validity of conventional Pap smear in diagnosis of cervical intraepithelial neoplasia in Erbil through comparison with colposcopy with or without cervical biopsy.Methods: A hospital-based study was carried out in Erbil Maternity Hospital from the 1st May to 31st December 2008. The study sample included 336 women attending the breast disease center for routine breast examination. Cervical Pap smear followed by colposcopic examination was done for each woman on the same day. Cervical punch biopsy was taken for those with abnormal colposcopic findings. Colposcopy with or without biopsy was considered as a gold standard diagnosis of cervical intraepithelial neoplasia (CIN).Results: Out of 336 women, 48 (14.3%) had abnormal cervical smear results, of which 43 (12.8%) of the total had low-grade cervical lesions and 5 (1.5%) of the total had high-grade cervical lesions. Colposcopy-directed biopsy revealed that 69 (20.5%) had abnormal findings of which 65 (19.3%) women had CIN I and 4 (1.2%) of the total had CIN II and III. The sensitivity and specificity of the cervical smear were 62.3% and 98.1%, respectively. The positive predictive value was 89.6% while the negative predictive value was 91%. The false negative percentage was 37.7%. The accuracy of the test was 90.8% and the degree of agreement between Pap smear and colposcopy with biopsy results was 90.2%.Conclusion: The high accuracy of cervical smear in this study and high agreement rate between cervical cytology and colposcopy indicates that conventional Pap smear is an important dependable screening test in spite of its low validity in terms of its sensitivity.


Article
Immunohistochemical Evaluation of the Frequency of Human Papillomavirus in Cervical Lesions in a Sample from the North Iraqi Population

Author: Ava Taher Ismael*, Rafal AbdulRazaq Al-Rawi*, Wahda M.T. AL-Nuaimy*
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 241-246
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Human papilloma virus has been linked to many types of cervical lesions, ranging from the relatively innocuous lesions to fatal invasive squamous cell carcinoma. There is growing evidence of Human papillomavirus being a relevant factor in other anogenital cancers (anus, vulva, vagina and penis) as well as head and neck cancers.OBJECTIVE:To assess the feasibility of immunohistochemical staining paraffin sections for the presence of Human papilloma virus with monoclonal antibodies (clone K1H8, IgG) raised against the major coat fusion capsid proteins and to detect the frequency of human papilloma virus immunoexpression in benign, preneoplastic and neoplastic cervical lesions in patients living in Erbil city ( North of Iraq).MATERIALS AND METHODS: A total of 75 paraffin blocks samples of cervical tissue were retrieved retrospectively from the Pathology Department of Maternity Teaching Hospital and some private laboratories in Erbil city, during a period spanning from September 2013 to June 2014. They were categorized as: Benign cervicitis (10) samples, cervical intraepithelial neoplasia, CIN I (33) samples, CIN II (10) samples, CIN III (13) samples, cervical squamous cell carcinoma (6) samples and three samples with cervical adenocarcinoma Immunohistochemistry was performed on those samples using the avidin -biotin-peroxidase complex in which primarily monoclonal anti Human papilloma virus antibodies was used. RESULTS: None of the 10 samples of benign cervicitis were positive for Human papillomavirus protein while 21 out of 33 (63.6%) samples of CINI, 9 out of 10 (90%) samples of CIN II and 9 out of 13 (69.2%) samples of CIN III were positive for HPV. Also Human papillomavirus positivity observed in all six samples of squamous cell carcinoma (100%), mostly in sheets of less mature squamous cells and in 1 out of 3 (33.3%) samples of adenocarcinoma , mostly focal and in single cell.CONCLUSION: The immunohistochemical staining technique revealed a significant detection of HPV protein in cervical intraepithelial neoplasia and cervical carcinoma. .


Article
The Molecular Detection of HPV Infection in samples of Iraqi Women with Abnormal cervical Smears

Authors: Mais N. Abdul-samad --- Nuha J. Kandala
Journal: Iraqi Journal of Science المجلة العراقية للعلوم ISSN: 00672904/23121637 Year: 2018 Volume: 59 Issue: 4B Pages: 1995-2004
Publisher: Baghdad University جامعة بغداد

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Abstract

Human papillomavirus (HPV) types 16 and 18 cause almost 70% of cervical cancer cases worldwide. Recently, testing for high-risk HPV types have been adopted by clinical practices for the early detection of cervical cancer in conjunction with cytology tests. Cervical swab samples were collected at the Outpatient Gynecology department of Baghdad Teaching Hospital. These samples consisted of a patient group of 50 samples, and a healthy control group of 10 samples. A papanicolaou test (abbreviated as a Pap test) was also performed for each woman to examine the epithelial cells of both the endocervix and the upper vaginal region. Total DNA (genomic, mitochondrial, and viral) was extracted from cervical swab samples for molecular studies. HPV DNA testing was first done by using Real-Time PCR technology to target the L1 region of HR-HPV with specifically designed primers. This was followed by using AmpliSens kit for specific detection and genotyping of HPV16 and 18 with multiplex Real-Time PCR. The results of RT-PCR detection revealed that out of 16 samples detected with high-risk HPV, 5 samples were shown to be infected with HPV-16 and 5 samples were shown to be infected with HPV-18. These results show a significant relationship between the histological outcome of the patient and persistent HPV infection.


Article
CERVICOVAGINAL SMEARS’ CLASSIFICATION USING THE BETHESDA SYSTEM (TBS) 2001: A CYTOPATHOLOGICAL STUDY

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Abstract

Background:The Bethesda System (TBS) aims to simplify cervical smear report and make it more reproducible and facilitates the communication between pathologist and clinician.Objectives:To evaluate 2001 Bethesda System of cervicovaginal smear classification in the diagnosis of different pathologies seen in women having different gynecological complaints.Methods:A prospective study of cervicovaginal smears that obtained from 360 female patients (aged 15-75 years) attending Gynecological Consultation Clinic in Al-Imamian Al-Kadhimiyian Medical City – Baghdad- Iraq for the period from November 2011 to April 2012. Smears were stained by Pap stain to evaluate according to Bethesda system 2001.Results:A total of 360 cases were evaluated, 317 cases (88%) had satisfactory smears for evaluation. 246 cases (68.3%) had negative cervical smears for intraepithelial neoplasia (TBS 2001). Seventy one cases (19.72%) had abnormal cervical smears (AS). Minimal cervical smear abnormalities (ASC-US, ASC-H, AGC, LSIL), includes (53) cases (74.64% of AS). HSIL (CIN- II, CIN-III, & carcinoma in situ), includes (18) cases (25.36% of AS).Conclusion:Pap smear is a screening test, it is not a diagnostic test; positive result indicates that there may be a problem and that further diagnostic procedures must be done. The Bethesda system is of validity in providing a uniform format for cervical cytology report.Key words:Pap smear, cervical intraepithelial Neoplasia (CIN), LSIL, HSIL, 2001 Bethesda System (TBS).


Article
P16INK4a Overexpression in Cervical Biopsies Collected from Women with Normal and Equivocal Pap Smears
التعبير المبالغ فيه لمادة P16INK4a في خزعات عنق الرحم من نساء لديهم مسحات سليمة وملتبسة

Authors: Thanaa JM Al-Khishali ثناء جميل الخشالي --- Nada Salih Ameen ندى صالح أمين --- Huda M Al-Khateeb هدى مهدي الخطيب
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2016 Volume: 29 Issue: 1 Pages: 16-25
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Cervical cancer is the third most common cancer among women worldwide Immunohistochemical expression of p16INK4a has been relatively well established in cervical biopsy specimens.Objectives: Our hypothesis is to evaluate the usefulness of p16 immunostaining on tissue sections in borderline cases. Methods: This is a case-control study with a total of cervical samples from 60 women (25-66 years age) divided into three groups (I, II and III). The study was conducted at the Colposcopy Clinic in Baghdad Teaching Hospital – Medical City Complex, during the period from June 2013 through July 2014. The samples were analyzed by cytopathology, histopathology and p16INK4a immunostaining.Results: Group I showed negative p16 reaction. Among group II; one (5%) showed mild positive, 9 (45%) moderate positive and 10 (50%) high positive reactions. Group III specimens showed p16 positivity. Conclusion: p16INK4a immunohistochemistry is one of the best candidates for histologically indeterminate lesions.

الخلفية: سرطان عنق الرحم هو ثالث أكثر أنواع السرطان شيوعا بين النساء في جميع أنحاء العالم. لقد تم نسبيا اثبات التعبير المناعى المبالغ فيه لمادة p16INK4a في عينات من خزعات عنق الرحم. فرضيتنا هي تقييم فائدة الصبغة المناعية P16 على شرائح الأنسجة في الحالات الملتبسة أو غير المتأكد من تشخيصها.الطريقة: هذه دراسة الحالات الافرادية المقترنة بحالات ضابطة (case-control study) لمجموعه من عينات عنق الرحم من 60 امرأة (25-66 سنة العمر) مقسمة إلى ثلاث مجموعات (الأولى والثانية والثالثة). أجريت هذه الدراسة في عيادة التنظير المهبلي في مستشفى بغداد التعليمي - مجمع مدينة الطب، خلال الفترة من حزيران 2013 حتى تموز 2014. وقد تمت دراسة العينات عن طريق الفحص الخلوي، مقاطع لشرائح عن طريق علم أمراض الأنسجة، ومقارنتها بالصبغة المناعية لمادة p16INK4a. النتائج: أظهرت نتائج المجموعة الأولى رد فعل سلبي لصبغة P16. أما نتائج المجموعة الثانية فكانت كالاتي: واحد (5٪) أظهر رد فعل إيجابي ضعيف، وتسعة 9 (45٪) متوسط الإيجابية و10 (50٪) أظهر رد فعل إيجابي عالي. أما المجموعة الثالثة فقد أظهرت العينات إيجابية عالية لمادة p16.

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