Volume 03 Issue 04-2023
121
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
121-124
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Cervical cancer has been found to have increased morbidity and mortality in women around the world. Despite
complex treatment according to stratification, the risk of relapse is observed in up to 40% of patients
Purpose of the study: -
Improving the result of early diagnosis of recurrence of cervical cancer stump after complex
treatment, by determining the value of the immune response by immunohistochemical markers in combination with
the results of complex research methods
Materials and methods: -
The basis of the research work was a retrospective analysis of the results of the examination
and complex treatment of 87 patients with cervical cancer who were treated and treated at the Republican Specialized
Scientific and Practical Center of Oncology and Radiology of Uzbekistan, as well as in its Samarkand Regional Branch
from 2012 to 2017. All patients underwent complex treatment of 4 courses of polychemotherapy according to the
scheme fluorouracil + cisplatin, laparotomy, extended hysterectomy according to Wertheim type and combined
radiation therapy of the small pelvis according to the BOX type.
All patients were divided into 2 groups. The first control group consisted of 32 (36.8%) patients with cervical cancer
who underwent complex treatment in various sequences, without relapse for three years. The second group included
55 (63.2%) patients with the same diagnosis, but in whom, after complex treatment, an early relapse was detected at
the preclinical stage.
Research Article
PREDICTION AND STUDY OF THE OCCURRENCE OF CERVICAL CANCER
RECURRENCE
Submission Date:
April 20, 2023,
Accepted Date:
April 25, 2023,
Published Date:
April 30, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue04-19
Ortikova Hilola Ubaydullayevna
Samarkand State Medical University. Samarkand. Uzbekistan
Esankulova Bustonoy Sobirovna
Samarkand State Medical University. Samarkand. Uzbekistan
Musayev Mexroj Bakhtiyorovich
Samarkand State Medical University. Samarkand. Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 04-2023
122
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
121-124
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Results: -
In the study of intense infiltrate with lymphoid follicles, it was mainly observed with the degree of tumor
differentiation G-3 and G-4, which amounted to 21 (80.7%) patients in the relapse group, while in the control group in
19 (61%) which significantly higher (p≤0.05). In group 1, negative expression was noted in highly and moderately
differentiated tumors 9 (29%). With low and undifferentiated tumors, moderate and high expression of VEGF (50%)
was noted, with further observation in these patients, locoregional recurrence was noted.
In the second group, where there was a relapse of the cervical stump by histological examination, high expression
with G-4 was noted in 8 (30.7%), and with G-3 moderate expression in 6 (23%) cases. Low intensity was observed only
in 1 (3.8%) G1.As can be seen in Table 4.2, negative expression during relapse, i.e. the absence of lymphoid
Conclusions: -
Based on our research, differences in cellular immunity play a significant role. In patients without
relapses, an increased cellular density of T3DM and T20 was observed, and in patients with relapses and severe course
of the disease, low lymphoid density.
We should note that in our study, the strongest predictor of prognosis is the number of CD3 + cells per mm 2.
KEYWORDS
Cervical cancer, relapse, combined radiation therapy, VEGF CD3 and CD20.
INTRODUCTION
According to the histological/cytological verification of
the material, it was revealed that a recurrence in the
cervical stump up to 1 cm in size was detected in 2
cases, in 7 cases - 1-2 cm, in 13 cases - an increase of
more than 2 cm.
When evaluating the values of the MRI results, true
negative - in 20 cases, there were no true suspicious,
false negative and false positive results.
The obtained data on the comparative evaluation of
the results of magnetic resonance imaging of patients
with CCRS showed that the sensitivity of MRI in
determining a recurrence of up to 1 cm is 66.7%, 1-2 cm
- 83%, more than 2 cm - 87.5%. The specificity of MRI in
determining CCC up to 1 cm is 83.3%, up to 2 cm 94.1%
and more than 2 cm - 83.3%. Diagnostic accuracy of MRI
up to 1 cm 90.5, 1-2 cm 93.9% and at more than 2 cm -
95.5%.
Contraindications to MRI are: diseases that do not
allow the patient to remain still during the
examination, claustrophobia, the presence of a
pacemaker or other electronic devices in the div of
the subject, as well as the first trimester of pregnancy,
but only if the woman wishes to continue the
pregnancy Thus, it has been established that The
effectiveness of MRI in determining the degree of
cervical cancer is dominated by ultrasound and allows
you to correctly determine the development of
recurrent cervical cancer.
The prevalence of the disease in the study populations
ranged from 40% to 89%. Our analysis revealed that the
correlation between colposcopic impression and
guided biopsy diagnosis (colposcopic accuracy) was
within one histological grade in 89% of cases, and was
in exact agreement with histological diagnosis in 61% of
cases.
Volume 03 Issue 04-2023
123
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
121-124
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
In colposcopy, in the diagnosis, the defeat of earlier
signs of relapse is taken as the maximum gradation, the
same with preclinical signs of relapse, the criterion is
taken as the minimum. This trend is however
considered quite low at 5%. The sensitivity of
colposcopy in differentiating normal from recurrent
cervical tissue varied within 86.9±4.7%, and the
specificity varied 67.4±3.5%. Tumor recurrence up to
1.0 cm was determined in 29 (52.7%) cases, 1.0 to 2.0 cm
- in 19 (34.5%) patients, more than 2.0 cm - in 7 (12.7%)
patients.
In 6 (10.9%) cases, the diagnosis of cervical cancer
recurrence was established on the basis of a
cytological examination after colposcopy with a swab,
since no signs of a tumor process were detected on
ultrasound.
Colposcopic studies of patients with CCRS showed that
the sensitivity in determining recurrence up to 1 cm is
95%, 1-2 cm - 90.9%, more than 2 cm - 93.2%. The
accuracy of colposcopy in the determination of CC is up
to 1 cm -76%, 1-2 cm -80%, more than 2 cm - 82%.
Diagnostic specificity up to 1 cm -60%, 1-2 cm -60%, more
than 2 cm - 83.3%.
The Bays method calculated the equivalent of
calculating the predictive value of each diagnostic test.
When studying in a comparative aspect the diagnostic
efficacy of CCPR at the preclinical stage of each
method, we were based on such criteria as the positive
predictive value fluctuated 89.8%, and the negative
predictive value - 78.5%.
This threshold shift is also reflected in a significant
increase in positive predictive values. This result shows
that colposcopy with cytological analysis in the
diagnosis of preclinical recurrence of cervical cancer.
The coefficient of probability of obtaining a specific
result for a given condition is presented in Diagram 3,
and a certain upward trend has been maintained
throughout all studies. The difference is much greater
with G3 than with G1.
This is further evidence that colposcopy is more
effective in diagnosing recurrence of G3 cervical
cancer.
CONCLUSIONS
In the diagnosis of recurrent cervical cancer stump
after complex and / or combined treatment, the value
of colposcopy is significantly higher than ultrasound
and MRI, so the sensitivity of colposcopy for
recurrence up to 1 cm was 95.5 ± 1.2%, the specificity
was 60.2 ± 4.3 %, accuracy 76±2.8%.
The sensitivity of ultrasound in determining recurrence
up to 1 cm is 80.0±2.3%, specificity is 62.5±3.8%,
accuracy is 84.2±6.6%. For MRI, the index of sensitivity,
specificity and accuracy is 66.7±3.6%, 90.5±2%.3%,
83.35±2.8%, respectively. There was no significant
difference in resolving capabilities in the diagnosis of
cervical cancer stump recurrence using ultrasound and
MRI (p>0.05). To determine changes in the cult, taking
into account the economic potential, the optimal
method is colposcopy with a high amount of
information sufficient to make a decision on the tactics
of treating this category of patients.
It has been established that overexpression of DM3+
and DM20+ is an independent unfavorable factor in the
prognosis of cervical cancer, and its expression level
increases at G3-G4. The density and level of lymphoid
infiltration can be considered as potential prognostic
markers of CCRS, since the level of their expression is
significantly
associated
with
the
degree
of
differentiation: overexpression increases with a
decrease in the degree of differentiation. (p<0.05).
Volume 03 Issue 04-2023
124
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
121-124
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
In the comparative aspect of the diagnostic efficiency
of CCPR at the preclinical stage, it statistically prevails
on such criteria as the positive predictive value
fluctuated 89.8%, and the negative predictive value -
78.5%, which increases the probability coefficients of
colposcopy to identify normal tissue from all sections
of abnormal tissue.
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