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  1. Article ; Online: Management of Cervical Intraepithelial Neoplasia in Pregnant Women.

    Stuebs, Frederik A / Koch, Martin C / Dietl, Anna K / Schulmeyer, Carla E / Behrens, Annika S / Seibold, Anja / Adler, Werner / Geppert, Carol / Hartman, Arndt / Knoll, Antje / Beckmann, Matthias W / Gass, Paul / Mehlhorn, Grit

    Anticancer research

    2023  Volume 43, Issue 7, Page(s) 3153–3158

    Abstract: Background/aim: The aims of the present study were to evaluate the accuracy of colposcopic findings, investigate the way in which untreated cervical intraepithelial neoplasia (CIN) 2/3 develops during pregnancy, and identify factors associated with ... ...

    Abstract Background/aim: The aims of the present study were to evaluate the accuracy of colposcopic findings, investigate the way in which untreated cervical intraepithelial neoplasia (CIN) 2/3 develops during pregnancy, and identify factors associated with regression, persistence, or progression rates.
    Patients and methods: In a tertiary gynecology and obstetrics department, 655 pregnant women were seen for colposcopy. The most common reason for referral was abnormal cytology findings. The follow-up findings were analyzed retrospectively on the basis of colposcopic findings and cytological and histological tests.
    Results: The rate of accuracy for major colposcopic findings was 89.2%. Among the colposcopic findings considered "suspicious for invasion" were invasive carcinoma in 42.9% and CIN 3 in 57.1%. The persistence of CIN 3 postpartum was 80% and the rate of progression 4.1%. The rate of regression for CIN 3 was 21.9%. For CIN 2, the rate of persistence was 37.5%, with a regression rate of 31.3%. The rate of regression was higher after vaginal delivery in comparison with caesarean section.
    Conclusion: The accuracy rate of colposcopy is comparatively high, at 89.2%. This might be because pregnant women are seen by more experienced examiners in our dysplasia unit. The rate of progression is comparable with that in other studies. Vaginal delivery increases the regression rate. The newborns' birth weight or birth week did not affect the rates of regression or persistence.
    MeSH term(s) Infant, Newborn ; Female ; Pregnancy ; Humans ; Uterine Cervical Neoplasms/pathology ; Pregnant Women ; Retrospective Studies ; Cesarean Section ; Uterine Cervical Dysplasia/pathology ; Colposcopy ; Vaginal Smears
    Language English
    Publishing date 2023-06-20
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 604549-2
    ISSN 1791-7530 ; 0250-7005
    ISSN (online) 1791-7530
    ISSN 0250-7005
    DOI 10.21873/anticanres.16488
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Cervical intraepithelial neoplasia grade 3: development during pregnancy and postpartum.

    Stuebs, Frederik A / Mergel, Franziska / Koch, Martin C / Dietl, Anna K / Schulmeyer, Carla E / Adler, Werner / Geppert, Carol / Hartman, Arndt / Knöll, Antje / Beckmann, Matthias W / Gass, Paul / Mehlhorn, Grit

    Archives of gynecology and obstetrics

    2022  Volume 307, Issue 5, Page(s) 1567–1572

    Abstract: Purpose: The aims of the present study were to evaluate the development of untreated cervical intraepithelial neoplasia (CIN) 3 during pregnancy and to assess persistence, progression, and regression rates postpartum to identify factors associated with ... ...

    Abstract Purpose: The aims of the present study were to evaluate the development of untreated cervical intraepithelial neoplasia (CIN) 3 during pregnancy and to assess persistence, progression, and regression rates postpartum to identify factors associated with regression.
    Methods: In a tertiary gynecology and obstetrics department, a total of 154 pregnant women with CIN 3 were treated in the dysplasia unit. The follow-up findings were analyzed retrospectively on the basis of histological, cytological, and human papillomavirus (HPV) testing of 154 pregnant women confirmed as having CIN 3 in colposcopically guided biopsies.
    Results: The rates of persistence, regression, and progression of CIN 3 in these women were 76.1%, 20% and 3.2%, respectively. Data for the delivery mode was available for 126 women. The rate of regression was almost twice as high with vaginal delivery as with cesarean section, at 27.4 vs. 15.2%, whereas the rate of progression was lower with vaginal delivery, at 2.7 vs. 6.5%.
    Conclusion: The rate of persistence of CIN observed in this study is comparable to that reported in other studies. The study provides strong evidence for greater regression among women who have vaginal deliveries. Careful work-up is recommended postpartum for this group of women in order to rule out persistent CIN 3 or invasive disease.
    MeSH term(s) Female ; Pregnancy ; Humans ; Uterine Cervical Neoplasms/pathology ; Retrospective Studies ; Cesarean Section ; Colposcopy ; Uterine Cervical Dysplasia/pathology ; Postpartum Period ; Papillomavirus Infections/complications ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/pathology ; Vaginal Smears
    Language English
    Publishing date 2022-10-22
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 896455-5
    ISSN 1432-0711 ; 0932-0067
    ISSN (online) 1432-0711
    ISSN 0932-0067
    DOI 10.1007/s00404-022-06815-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Reply to Yongbao Wei, Haijian Huang, and Liefu Ye's Letter to the Editor re: George J. Netto, Mahul B. Amin, Daniel M. Berney, et al. The 2022 World Health Organization Classification of Tumors of the Urinary System and Male Genital Organs-Part B: Prostate and Urinary Tract Tumors. Eur Urol. 2022;82:469-82.

    Rubin, Mark A / Amin, Mahul B / Compérat, Eva / Gill, Anthony / Hartman, Arndt / Menon, Santosh / Raspollini, Maria / Srigley, John / Tan, Puay Hoon / Ticktoo, Satish / Tsuzuki, Toyonori / Turajlic, Samra / Cree, Ian / Berney, Daniel / Moch, Holger / Netto, George J

    European urology

    2022  Volume 83, Issue 1, Page(s) e16–e17

    MeSH term(s) Humans ; Male ; Prostate ; Prostatic Neoplasms ; Urologic Neoplasms ; Urinary Tract ; World Health Organization
    Language English
    Publishing date 2022-10-04
    Publishing country Switzerland
    Document type Letter
    ZDB-ID 193790-x
    ISSN 1873-7560 ; 1421-993X ; 0302-2838
    ISSN (online) 1873-7560 ; 1421-993X
    ISSN 0302-2838
    DOI 10.1016/j.eururo.2022.09.021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Concordance rate of vulvoscopic findings in detecting early vulvar neoplasia.

    Stuebs, Frederik A / Mehlhorn, Grit / Gass, Paul / Schulmeyer, Carla E / Adler, Werner / Strehl, Johanna / Hartman, Arndt / Beckmann, Matthias W / Renner, Simone K / Koch, Martin C

    Gynecologic oncology

    2020  Volume 157, Issue 2, Page(s) 463–468

    Abstract: Purpose: Colposcopy-guided punch biopsy is a cornerstone method for diagnosing vulvar diseases. The aim of this study was to evaluate the concordance rate of clinical findings in vulvar diseases during examinations, in comparison with colposcopy- ... ...

    Abstract Purpose: Colposcopy-guided punch biopsy is a cornerstone method for diagnosing vulvar diseases. The aim of this study was to evaluate the concordance rate of clinical findings in vulvar diseases during examinations, in comparison with colposcopy-directed punch biopsy. We also developed a new classification to simplify the categorization of vulvoscopic findings.
    Methods: The concordance rate of the clinical findings was compared with the final histology results from punch biopsies. The data were collected between January 2014 and May 2017 at the Erlangen University Hospital.
    Results: A total of 482 colposcopy-directed punch biopsies of the vulva were obtained in 420 women. The overall concordance rate of the clinical findings in comparison with the histological vulvar punch-biopsy findings was 53.9% for all entities - benign lesions, lichen, low- and high-grade squamous intraepithelial lesions (LSIL/HSILs), and vulvar carcinoma. The concordance rate for detecting LSILs was 64.3% (45/70). The concordance rate for detecting HSILs was 62.3% and for Vulvar carcinoma 65.2%.
    Conclusions: Punch biopsy of suspicious lesions continues to be a cornerstone in diagnosing HSILs and carcinoma of the vulva. Careful work-up of the vulva is recommended when patients have symptoms such as pruritus or pain. The new classification is more specific for diagnosing lesions in the vulva.
    MeSH term(s) Adult ; Biopsy/methods ; Carcinoma in Situ/diagnosis ; Carcinoma in Situ/pathology ; Colposcopy/methods ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Vulvar Neoplasms/diagnosis ; Vulvar Neoplasms/pathology
    Language English
    Publishing date 2020-02-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2020.02.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Accuracy of colposcopic findings in detecting vaginal intraepithelial neoplasia: a retrospective study.

    Stuebs, Frederik A / Koch, Martin C / Mehlhorn, Grit / Gass, Paul / Schulmeyer, Carla E / Hartman, Arndt / Strehl, Johanna / Adler, Werner / Beckmann, Matthias W / Renner, Simone K

    Archives of gynecology and obstetrics

    2020  Volume 301, Issue 3, Page(s) 769–777

    Abstract: Purpose: Malignancies of the vagina are rare, but colposcopy-directed biopsies play a major role in detecting vaginal intraepithelial lesions. Data of accuracy in detecting neoplasia of the vagina are very rare compared to accuracy in detecting cervical ...

    Abstract Purpose: Malignancies of the vagina are rare, but colposcopy-directed biopsies play a major role in detecting vaginal intraepithelial lesions. Data of accuracy in detecting neoplasia of the vagina are very rare compared to accuracy in detecting cervical neoplasia. The aim of this study was to evaluate the accuracy of colposcopy-directed biopsy in comparison with clinical findings of the examiner.
    Methods: The accuracy of colposcopy-directed biopsy was compared with the clinical finding in relation to the patient's age and the examiner's level of training. This was done in combination with PAP-smear, HPV-test results, and the history of other malignancies of the lower genital tract. The data were collected between January 2014 and February 2018 at the certified Dysplasia Unit of the University Hospital Erlangen.
    Results: In total, 253 biopsies from 253 women from the vagina were obtained. The overall accuracy of biopsy in comparison with clinical finding was 52.17% for all entities-benign lesions, low-grade squamous intraepithelial lesions (LSILs), high-grade squamous intraepithelial lesions (HSILs), and vaginal carcinoma. The accuracy for detecting HSIL was 82.46% (47/57), with an underdiagnosis rate of 15.79% and an overdiagnosis rate of 1.79%.
    Conclusion: With a sensitivity of over 80%, colposcopy-directed biopsy plays an important role in detecting vaginal-HSIL. A highly experienced practitioner is increasing the sensitivity in detecting vaginal-HSIL. Careful examination is required in women with a history of HSIL of the lower genital tract or with simultaneous neoplasia because they are of greater risk of developing vaginal malignancies. The combination of careful clinical work up, PAP-smear, HPV-testing, and colposcopy-guided biopsy is crucial in detecting vaginal-HSIL.
    MeSH term(s) Adult ; Cervical Intraepithelial Neoplasia/diagnosis ; Cervical Intraepithelial Neoplasia/pathology ; Cervical Intraepithelial Neoplasia/surgery ; Colposcopy/methods ; Female ; Humans ; Retrospective Studies ; Vaginal Neoplasms/diagnosis ; Vaginal Neoplasms/pathology ; Vaginal Neoplasms/surgery
    Language English
    Publishing date 2020-01-28
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 896455-5
    ISSN 1432-0711 ; 0932-0067
    ISSN (online) 1432-0711
    ISSN 0932-0067
    DOI 10.1007/s00404-020-05441-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Multicenter clinical validation of PITX2 methylation as a prostate specific antigen recurrence predictor in patients with post-radical prostatectomy prostate cancer.

    Bañez, Lionel L / Sun, Leon / van Leenders, Geert J / Wheeler, Thomas M / Bangma, Chris H / Freedland, Stephen J / Ittmann, Michael M / Lark, Amy L / Madden, John F / Hartman, Arndt / Weiss, Gunter / Castaños-Vélez, Esmeralda

    The Journal of urology

    2010  Volume 184, Issue 1, Page(s) 149–156

    Abstract: Purpose: Radical prostatectomy is potentially curative in patients with clinically localized prostate cancer. However, biochemical recurrence affects 15% to 30% of men who undergo radical prostatectomy. We previously reported the prognostic potential of ...

    Abstract Purpose: Radical prostatectomy is potentially curative in patients with clinically localized prostate cancer. However, biochemical recurrence affects 15% to 30% of men who undergo radical prostatectomy. We previously reported the prognostic potential of PITX2 gene promoter methylation using conventional assays. In the current study we validated PITX2 methylation status as a biochemical recurrence predictor after radical prostatectomy using a novel microarray based platform in a multi-institutional setting.
    Materials and methods: PITX2 methylation status was assessed in formalin fixed, paraffin embedded prostatectomy tumor tissue samples from 476 patients from a total of 4 institutions on customized EpiChip PITX2 microarrays. Associations between PITX2 methylation and biochemical recurrence were assessed using the log rank test and Cox regression controlling for prostate cancer features.
    Results: On multivariate analysis men with high methylation status were at significantly higher risk for biochemical recurrence than those with low methylation status (HR 3.0, 95% CI 2.0-4.5, p <10(-5)). The biochemical recurrence-free survival rate 5 years after surgery was 85% and 61% in the low and high methylation groups, respectively. In men with pathological Gleason 7 tumors the relative risk of biochemical recurrence was twice as high for high than for low PITX2 methylation (HR 2.0, 95% CI 1.2-3.3, p = 0.005).
    Conclusions: PITX2 methylation status assessed by EpiChip PITX2 identifies patients with prostate cancer who are most likely to have biochemical recurrence. This test independently adds to the prognostic information provided by standard clinicopathological analysis, improving prostatectomy case stratification into those at high and low risk for biochemical recurrence. This new clinical tool would be of particular benefit to assess intermediate risk cases (Gleason 7) in which risk stratification remains a challenge.
    MeSH term(s) Adenocarcinoma/genetics ; Adenocarcinoma/surgery ; Adult ; Aged ; Biomarkers, Tumor/blood ; DNA Methylation ; Homeodomain Proteins/genetics ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/genetics ; Polymerase Chain Reaction ; Prognosis ; Promoter Regions, Genetic ; Proportional Hazards Models ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/genetics ; Prostatic Neoplasms/surgery ; Retrospective Studies ; Survival Rate ; Transcription Factors/genetics ; Homeobox Protein PITX2
    Chemical Substances Biomarkers, Tumor ; Homeodomain Proteins ; Transcription Factors ; Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2010-05-15
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Validation Study
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1016/j.juro.2010.03.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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