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P1072 Comparison of the diagnostic accuracy of pipelle biopsy, dilatation and curettage and hysterectomy in detection of endometrial lesions
S712
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
in patients with locally advanced cervical cancer with intravenous iron supplementation. Study type: A prospective randomised trial is presented, comparing the use of packed red cells with intravenous iron therapy in women with inoperable cervical cancer. Materials: Thirty nine patients with locally advanced cervical cancer (FIGO II B to IV B) and anemia (Haemoglobin less than 12 g/dL) were recruited from the Pretoria Academic Hospital complex’s oncology clinics. Patients were randomised into two groups prior to receiving chemoradiation. One group received an autologous packed red cell transfusion and the other intravenous iron therapy. Method: The patients’ haemoglobin (Hgb) levels and iron status were evaluated prior to treatment. Patients were randomised to the packed red cell group or the intravenous iron group. Patients received treatment depending on the group they were randomised to. Patients were followed up at three, six and twelve weeks post treatment to assess the effect of the treatment on haemoglobin levels. Data was collected at regular intervals and results were evaluated. Results: Thirty nine patients with cervical cancer (FIGO stage IIB to IV B) had sufficient data to analyse. Nineteen were randomised to the intravenous iron arm and twenty to the packed red cell arm. The iron status of the majority of the patients reflected anemia with severely depleted iron stores. All patients qualified for the diagnosis of iron deficiency anemia. Follow up results proved packed red cells to be the ideal rescue treatment, but that there was a decline in haemoglobin after the transfusion. Intravenous iron replaced the depleted iron stores and patients showed a gradual increase in haemoglobin levels. Conclusion: Neither packed red cells nor intravenous iron replacement alone is ideal to treat anemia in cervical cancer patients prior to chemo radiation. P1070 Vulva cancer in HIV positive patients A. Mouton1 , G. Dreyer1 , B. Lindeque. 1 University of Pretoria, Dept of Obstetrics and Gyanecology, 2 Objective: This retrospective audit examines the patient and tumour profile of HIV positive patients with vulva cancer. Methods and Materials: Patients diagnosed at Pretoria Academic Hospital between January 2006 and December 2007 with any vulva malignancy, were identified by searching histopathology records. Information was available for a total of twenty five patients. The following data was collected: age, HIV status, CD4 count, histological subtype, stage of the disease and management. Results: Ten patients were HIV positive and fifteen tested negative. The median age of the HIV positive women was 31 years, and of the HIV negative women median was 51 years. FIGO stage distribution was as follows: 6 patients with stage II disease, 3 with stage III and 1 with stage IVA. There were 7 squamous carcinomas, 1 Burkett’s lymphoma, 1 Kaposi sarcoma and 1 small cell carcinoma. The average CD4 count was 187. Six patients were managed with radical vulvectomy and node dissection, one patient received primary chemotherapy (small cell carcinoma), and three patients received primary radiotherapy. In HIV positive patients who were operated none had lymph node disease. Conclusion: Of the 25 patients seen in 18 months with vulva malignancies, 10 patients were HIV positive. The median age of the HIV positive group was much younger. It appears that vulva carcinoma in immuno-suppressed women is locally aggressive without increased lymphatic spread but further studies are needed.
P1071 IL4 mutations in patients infected with high risk HPV and abnormal cervical smears D. Muresan, I. Rotar, F. Stamatian. University of Medicine “Iuliu Hatieganu” Cluj-Napoca, Romania Objectives: High risk Human Papiloma Virus are mandatory present in high grade cervical intraepithelial neoplasia and cervical cancer but other co-carcinogenetic factors may also be involved. A particularity of the immune system can facilitate the progression of HPV infection. We have try to identify the imunologic modifications that facilitate the persistence and the evolution of high risk HPV. Materials and Methods: We have performed a transversal case control study in order to see the relations between different IL4 mutations and the progression of HPV. IL4 is an important TH2 interleukin that was chosen for the study, knowing that in high grade lesions and in cervical cancer there are immunological modifications, and a shift to a Th2-type cytokine pattern occurs. The controls were HPV HR negative with negative cytology and the cases were represented by patients with abnormal cytology results: LSIL, HSIL HPV HR+. A separate category was represented by LSIL HR−. The results confirm the existence of immunologic modifications, but further studies are necessary involving the detection not only of different mutations but also of the serum and cervical IL4 levels. Conclusions: patients with abnormal cervical smear and positive HR HPV may be further discriminated in wery high risk grup by the analysis of their imunologic status. P1072 Comparison of the diagnostic accuracy of pipelle biopsy, dilatation and curettage and hysterectomy in detection of endometrial lesions T. Naderi Introduction: The current study has been designed to compare the diagnostic value of pipelle sampling as a simple and cost effective method with that of more complicated and expensive methods in the detection of pathologies in abnormal uterine bleedings. Method: In 60 patients scheduled for hysterectomy due to persistent uterine bleeding endometrial sampling was done twice, once with pipelle and then by D&C prior th the hysterectomy. First the pathological reports of pipelle and D&C specimens were compared with each other and the both were compared with hysterectomy as the gold standard. Results: In all cases pipelle was passed to the uterine cavity without any cervical dilatation and anesthesia. The most frequent results in all three kinds of sampling were proliferate endometrium and early secretory phase respectively. According to the pathological reports, pipelle and D&C in 89% of the cases, pipelle and hysterectomy in 80% of the cases and D&C and hysterectomy in 90% of the cases showed agreement, that shows so significant difference in diagnostic accuracy among three methods. Conclusion: Considering high agreement between pathological reports of pipelle biopsy as an outpatient method and those of D&C and hysterectomy, pipelle sampling is suggested as the first diagnostic procedure, while D&C and hysterectomy that necessiate anesthesia and take more time and expense should be reserved for just special cases. P1073 Prevalence of cervical squamous intraepithelial lesions among HIV positive women in Uganda C. Nakisige, B. Pande. Makerere University/Mulago Hospital, Department of Obstetrics/Gynaecology, Kampala, Uganda Objectives: 1. To determine the prevalence of Cervical Squamous Intraepithelial lesions (SIL) among HIV positive women in Uganda;
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
in patients with locally advanced cervical cancer with intravenous iron supplementation. Study type: A prospective randomised trial is presented, comparing the use of packed red cells with intravenous iron therapy in women with inoperable cervical cancer. Materials: Thirty nine patients with locally advanced cervical cancer (FIGO II B to IV B) and anemia (Haemoglobin less than 12 g/dL) were recruited from the Pretoria Academic Hospital complex’s oncology clinics. Patients were randomised into two groups prior to receiving chemoradiation. One group received an autologous packed red cell transfusion and the other intravenous iron therapy. Method: The patients’ haemoglobin (Hgb) levels and iron status were evaluated prior to treatment. Patients were randomised to the packed red cell group or the intravenous iron group. Patients received treatment depending on the group they were randomised to. Patients were followed up at three, six and twelve weeks post treatment to assess the effect of the treatment on haemoglobin levels. Data was collected at regular intervals and results were evaluated. Results: Thirty nine patients with cervical cancer (FIGO stage IIB to IV B) had sufficient data to analyse. Nineteen were randomised to the intravenous iron arm and twenty to the packed red cell arm. The iron status of the majority of the patients reflected anemia with severely depleted iron stores. All patients qualified for the diagnosis of iron deficiency anemia. Follow up results proved packed red cells to be the ideal rescue treatment, but that there was a decline in haemoglobin after the transfusion. Intravenous iron replaced the depleted iron stores and patients showed a gradual increase in haemoglobin levels. Conclusion: Neither packed red cells nor intravenous iron replacement alone is ideal to treat anemia in cervical cancer patients prior to chemo radiation. P1070 Vulva cancer in HIV positive patients A. Mouton1 , G. Dreyer1 , B. Lindeque. 1 University of Pretoria, Dept of Obstetrics and Gyanecology, 2 Objective: This retrospective audit examines the patient and tumour profile of HIV positive patients with vulva cancer. Methods and Materials: Patients diagnosed at Pretoria Academic Hospital between January 2006 and December 2007 with any vulva malignancy, were identified by searching histopathology records. Information was available for a total of twenty five patients. The following data was collected: age, HIV status, CD4 count, histological subtype, stage of the disease and management. Results: Ten patients were HIV positive and fifteen tested negative. The median age of the HIV positive women was 31 years, and of the HIV negative women median was 51 years. FIGO stage distribution was as follows: 6 patients with stage II disease, 3 with stage III and 1 with stage IVA. There were 7 squamous carcinomas, 1 Burkett’s lymphoma, 1 Kaposi sarcoma and 1 small cell carcinoma. The average CD4 count was 187. Six patients were managed with radical vulvectomy and node dissection, one patient received primary chemotherapy (small cell carcinoma), and three patients received primary radiotherapy. In HIV positive patients who were operated none had lymph node disease. Conclusion: Of the 25 patients seen in 18 months with vulva malignancies, 10 patients were HIV positive. The median age of the HIV positive group was much younger. It appears that vulva carcinoma in immuno-suppressed women is locally aggressive without increased lymphatic spread but further studies are needed.
P1071 IL4 mutations in patients infected with high risk HPV and abnormal cervical smears D. Muresan, I. Rotar, F. Stamatian. University of Medicine “Iuliu Hatieganu” Cluj-Napoca, Romania Objectives: High risk Human Papiloma Virus are mandatory present in high grade cervical intraepithelial neoplasia and cervical cancer but other co-carcinogenetic factors may also be involved. A particularity of the immune system can facilitate the progression of HPV infection. We have try to identify the imunologic modifications that facilitate the persistence and the evolution of high risk HPV. Materials and Methods: We have performed a transversal case control study in order to see the relations between different IL4 mutations and the progression of HPV. IL4 is an important TH2 interleukin that was chosen for the study, knowing that in high grade lesions and in cervical cancer there are immunological modifications, and a shift to a Th2-type cytokine pattern occurs. The controls were HPV HR negative with negative cytology and the cases were represented by patients with abnormal cytology results: LSIL, HSIL HPV HR+. A separate category was represented by LSIL HR−. The results confirm the existence of immunologic modifications, but further studies are necessary involving the detection not only of different mutations but also of the serum and cervical IL4 levels. Conclusions: patients with abnormal cervical smear and positive HR HPV may be further discriminated in wery high risk grup by the analysis of their imunologic status. P1072 Comparison of the diagnostic accuracy of pipelle biopsy, dilatation and curettage and hysterectomy in detection of endometrial lesions T. Naderi Introduction: The current study has been designed to compare the diagnostic value of pipelle sampling as a simple and cost effective method with that of more complicated and expensive methods in the detection of pathologies in abnormal uterine bleedings. Method: In 60 patients scheduled for hysterectomy due to persistent uterine bleeding endometrial sampling was done twice, once with pipelle and then by D&C prior th the hysterectomy. First the pathological reports of pipelle and D&C specimens were compared with each other and the both were compared with hysterectomy as the gold standard. Results: In all cases pipelle was passed to the uterine cavity without any cervical dilatation and anesthesia. The most frequent results in all three kinds of sampling were proliferate endometrium and early secretory phase respectively. According to the pathological reports, pipelle and D&C in 89% of the cases, pipelle and hysterectomy in 80% of the cases and D&C and hysterectomy in 90% of the cases showed agreement, that shows so significant difference in diagnostic accuracy among three methods. Conclusion: Considering high agreement between pathological reports of pipelle biopsy as an outpatient method and those of D&C and hysterectomy, pipelle sampling is suggested as the first diagnostic procedure, while D&C and hysterectomy that necessiate anesthesia and take more time and expense should be reserved for just special cases. P1073 Prevalence of cervical squamous intraepithelial lesions among HIV positive women in Uganda C. Nakisige, B. Pande. Makerere University/Mulago Hospital, Department of Obstetrics/Gynaecology, Kampala, Uganda Objectives: 1. To determine the prevalence of Cervical Squamous Intraepithelial lesions (SIL) among HIV positive women in Uganda;