Indian Journal of Cancer
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   2006| July-September  | Volume 43 | Issue 3  
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Prevalence of high - risk human papillomavirus infections in women with benign cervical cytology: A hospital based study from North India
R Aggarwal, S Gupta, R Nijhawan, V Suri, A Kaur, V Bhasin, SK Arora
July-September 2006, 43(3):110-116
DOI:10.4103/0019-509X.27932  PMID:17065768
INTRODUCTION: Cervical cancer is the commonest cancer among Indian women. High-risk human papillomavirus (HPV) detection holds the potential to be used as a tool to identify women, at risk for subsequent development of cervical cancer. There is a pressing need for identifying prevalence of asymptomatic cervical HPV infection in the local population. OBJECTIVE: To determine the prevalence of high-risk HPV DNA in women with benign cervical cytology. MATERIALS AND METHODS: Women visiting the gynecology outpatient with varied complaints were subjected to Pap smear. Four hundred and seventy two samples were subjected to polymerase chain reaction, using consensus primers for low and high-risk HPV (types 6, 11, 16, 18, 31 and 33). The samples that were positive for HPV DNA were subsequently assessed for high-risk consensus primers, types 16, 18, 31 and 33 as well as for HPV type 16 and 18. RESULTS: One hundred and seventy four (36.8%) women tested positive for HPV DNA. Thirty nine (8.2%) of the entire cohort tested positive for high-risk HPV. Fifteen samples were positive for type 16, 22 for type 18 and two for both types 16 and 18. A statistically higher prevalence of high-risk HPV was observed in poorly educated and rural groups. No association of HPV prevalence was noted with age, parity and age at marriage. CONCLUSION: The study generates epidemiological data of prevalence of sub-clinical HPV in the women visiting a tertiary care institute as well as peripheral health centres. The data generated will be useful for laying guidelines for mass screening of HPV, treatment and prophylaxis in the local population.
  7,857 939 24
Tobacco use among school children in Chennai city, India
PD Madan Kumar, S Poorni, S Ramachandran
July-September 2006, 43(3):127-131
DOI:10.4103/0019-509X.27935  PMID:17065771
AIMS: The present study was done to build a database on prevalence of tobacco use among students of grade 8 to 10 in Chennai city, for the purpose of advocacy of tobacco control and planning tobacco control interventions and evaluation. MATERIALS AND METHODS: A two-stage stratified probability sample of students in grades 8-10 corresponding to 13 to 15 years of age were selected from private/government aided private schools and purely government aided corporation schools. Data was collected by a pretested, closed-ended self-administered questionnaire. RESULTS: A total of 1255 students participated in this survey. Among them 64.4 boys and 35.6% were girls. Ever tobacco use was reported by 37.6% of the students (41.6 males and 30.2% females). Current users of tobacco (any products) were reported by 41.1% of the students. Prevalence was more among boy students (46.3%) when compared to that of girl students (31.6%). There existed no significant difference between current users of tobacco based on the zones of the school. Tobacco users prevalence was found more in corporation schools when compared to that of private schools. Parental and friends tobacco use was reported more often by tobacco users compared to never users. Purchasing tobacco products in a store was reported by 82.5% and almost no one was refused because of age. Almost everyone reported watching a lot of cigarette advertisements on TV, whereas about half reported watching advertisements on other medias like outdoor hoardings (45.7%), newspapers (65.3%) and social events (67.4%). CONCLUSION: This study demonstrates that among the 13 to 15-year old school going children (corresponding to grades 8 to 10) in Chennai city, the current tobacco use is high.
  8,004 760 22
Neoadjuvant chemotherapy followed by surgical cytoreduction in advanced epithelial ovarian cancer
SVS Deo, Hemant Goyal, NK Shukla, V Raina, Lalit Kumar, G Srinivas
July-September 2006, 43(3):117-121
DOI:10.4103/0019-509X.27933  PMID:17065769
AIMS: To study the role of neoadjuvant chemotherapy (NACT) followed by surgical cytoreduction in the management of advanced epithelial ovarian cancers. MATERIALS AND METHODS: A retrospective analysis of 82 patients with advanced epithelial ovarian cancers (stage IIIC and IV) who were treated with NACT followed by surgical cytoreduction between 1995 and 2004 was performed. Response to NACT, optimal cytoreduction rate, disease-free survival and overall survival were analyzed. RESULTS: There were 59 patients (72%) with stage IIIC disease and 23 (28%) with stage IV disease. Diagnosis was established by imaging, ascitic fluid cytology and CA-125 estimations in 75% and by laparotomy in 25% of the patients. After NACT, complete response occurred in 17 patients (20.7%), 50 (61.0%) had partial response and no response was documented in 15 (18.3%) patients. Optimal surgical cytoreduction could be achieved in 72% of the patients. At the median follow-up of 34 months (range 6-102 months), 5-year disease-free and overall survivals were 31 and 32% respectively. The median disease free interval was 25.4 months. On multivariate analysis, degree of optimal cytoreduction was the only factor ( P <0.05) affecting survival. CONCLUSIONS: NACT followed by surgical cytoreduction is a promising treatment strategy for the management of advanced epithelial ovarian cancers. A significant number of patients exhibit response to NACT. Downstaging following NACT leads to higher optimal cytoreduction rates and improved survival in comparison to historical controls.
  5,952 646 7
Second echelon node predicts metastatic involvement of additional axillary nodes following sentinel node biopsy in early breast cancer
KK Bassi, V Seenu, UK Ballehaninna, R Parshad, S Chumber, A Dhar, SD Gupta, R Kumar, A Srivastava
July-September 2006, 43(3):103-109
DOI:10.4103/0019-509X.27931  PMID:17065767
BACKGROUND : In many patients with early breast cancer, the sentinel lymph node (SLN) is the sole site of regional nodal metastasis. This subgroup of patients may not benefit from completion axillary lymph node dissection (CALND). AIMS: This pilot study evaluates the status of 2nd echelon (station) lymph nodes in the axilla as a predictor of additional positive nodes in the axilla in the presence of sentinel node metastasis. SETTINGS AND DESIGN: Cross-sectional study of 40 breast cancer patients. MATERIALS AND METHODS: Forty patients with invasive breast cancer underwent SLN biopsy followed by 2nd echelon lymph node biopsy in the same sitting. SLN mapping was performed using a combined technique of isosulfan blue and 99 mTc-sulfur colloid. SLNs (Station I) were defined as blue and/or hot nodes. These nodes were then injected with 0.1 ml of blue dye using a fine needle and their efferent lymphatic was traced to identify the Station II nodes. Then a complete ALND was performed. All the specimens were sent separately for histopathological evaluation. RESULTS : SLNs (Station I nodes) were successfully identified in 98% (39/40) patients. Of the 17 patients with a positive SLN, 8 (47%) patients had no further positive nodes in the axilla, 9 (53%) patients had additional metastasis in nonsentinel lymph nodes upon CALND. Station II nodes were identified in 76% (13/17) patients with a positive SLN. Station II nodes accurately predicted the status of the remaining axilla in 92% patients (12/13). STATISTICAL ANALYSIS : We calculated the Sensitivity, Negative predictive value, Positive predictive value, False negative rate and Identification rate. CONCLUSION : Station II nodes may predict metastatic involvement of additional nodes in the axilla.
  5,745 387 4
Study of the RET gene and his implication in thyroid cancer: Morocco case family
A Ainahi, M Kebbou, M Timinouni, N Benabdeljalil, T Fechtali, S Oufara, S El Antri
July-September 2006, 43(3):122-126
DOI:10.4103/0019-509X.27934  PMID:17065770
BACKGROUND: Multiple endocrine neoplasia type 2A (MEN 2A) is an autosomal dominant inherited cancer syndrome that affects multiple tissues derived from the neural crest. Inheritance of MTC is related to the presence of specific mutations in the RET proto-oncogene. Almost all mutations in MEN 2A involve one of the cysteines in the extracellular domain of the RET receptor. AIMS: The objective of the present study was the biochemical and molecular characterization of the first Moroccan clinically established MEN 2A patient and at-risk family members. SETTINGS AND DESIGN: This is a study on a family presented with MTC referred to our institute in 2004. MATERIALS AND METHODS: Peripheral blood leukocyte DNA samples were isolated and amplified by polymerase chain reaction followed by restriction enzyme analysis and DNA sequencing. RESULTS: We identified a heterozygous germ line missense mutation at codon 634 of exon 11 in the RET gene that causes a cysteine to arginine amino acid substitution in the DNA of the proband; this mutation was not found in the DNA of the parents or relatives. CONCLUSIONS: The detection of mutated MEN 2A gene carriers enables us to differentiate high-risk members from those who bear the wild-type gene. Occasionally, application of RET proto-oncogene testing may lead to the detection of unexpected de novo mutation that could be transmitted to children.
  4,944 421 4
Successful complete regression of isolated intramedullary spinal cord metastases from epithelial ovarian carcinoma with chemotherapy and radiotherapy
A Bakshi, G Biswas, C Deshmukh, N Prasad, R Nair, PM Parikh
July-September 2006, 43(3):136-138
DOI:10.4103/0019-509X.27937  PMID:17065773
Advances in the management of ovarian cancer by use of aggressive surgery and effective platinum-based chemotherapy have prolonged survival; this may have resulted in an alteration of the metastatic pattern of the disease and spread to unusual sites (e.g., CNS) has become more common. Also, with the availability of more sensitive imaging techniques, these tumors are being diagnosed with increasing frequency. Intramedullary spinal cord metastasis is rare. We report one such case treated successfully with chemotherapy and radiotherapy with long-term survival.
  4,336 347 11
Reducing the number of sentinel nodes removed in melanoma patients: A prospective study
AM Danino, N Kadlub, S Dalac, C Boichot, G Malka
July-September 2006, 43(3):132-135
DOI:10.4103/0019-509X.27936  PMID:17065772
CONTEXT: Since 1992, sentinel lymph node (SLN) biopsy was generally applied to melanoma for tumor staging. As the literature points out, an increasing number of nodes are being removed for each procedure, driving up the cost for this procedure and wandering away from the defining concept of sentinel lymph node. AIMS: The objective of the current study was to show that the number of sentinel lymph node s removed can be minimized without influencing the reliability of tumor staging. MATERIALS AND METHODS: We conducted a single-arm prospective study in patients with stage I melanoma. For each patient, the sentinel lymph node was identified using the hand-held gamma probe technique. We removed only the hottest nodes as well as the nodes with radioactivity greater than 70% compared to the hottest. We analyzed the characteristics of each melanoma, the success rate of this procedure, how many nodes were removed and how many had micro metastases. STATISTICAL ANALYSIS: The results were compared to those of the literature, previously published Porter study using the chi-square test. RESULTS: We included 90 patients. The success rate of this technique was 100%. We dissected 1.3 sentinel lymph nodes for each patient, with 22% positive SLN. Statistical analyses point out a better selectivity of our study for a similar rate of pathological positivity and recurrence compared to the literature. CONCLUSIONS: Our technique for decreasing the number of sentinel lymph nodes removed is reliable. The removal of minimal number of nodes doesn't compromise the sensitivity of tumor staging, while it does reduce the cost of the procedure.
  2,965 293 -
The relevance of cervical cancer screening and the future of cervical cancer control in India in the light of the approval of the vaccine against cervical cancer
M Basu
July-September 2006, 43(3):139-139
DOI:10.4103/0019-509X.27938  PMID:17065774
  2,775 348 3
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