Chapters authored
Biotechnologies Involved in Differentiation of Cervical Lesions
The purpose of this paper is to describe the updated biotechnologies approved to be used for identifying precancerous cervical lesions in clinical practice. The paper focuses on the new biotechnologies able to detect human papillomavirus (HPV) such as nucleic acid hybridization assays, signal amplification assays, and nucleic acid amplification. Particular attention is given to the discussion regarding the differences among the biotechnologies used, such as Digene Hybrid Capture test using Hybrid Capture 2 technology and the Cervista HR-HPV assay. The scientific progress is emphasized by new markers such as cycline p16INK4a, viral oncoproteins E6 and E7, high-risk (HR) HPV genotyping, and dual test p16/Ki67. The results of the large ongoing studies conducted worldwide highlight these markers’ capacity to disclose the differences between transient and transforming HPV infection and mild abnormal cytologies which could spontaneously regress or develop into cancer. Although both screening programs and opportunistic screening concerning cervical cancer are used worldwide, major geographic differences exist nowadays as regards the access to these programs. Finally, to achieve the objective of this study, the recommendations of various guidelines available across Europe, United States, and Australia, as well as the diagnosis tests accessible to women in low-resource countries are presented.
Part of the book: Human Papillomavirus
Breast and Cervix Uteri: Rare Locations for Mycobacterium Tuberculosis Infections and Complications-Cases Report and Literature Review
Breast and cervix uteri are rare locations for Mycobacterium tuberculosis (MbT) infection and MbT association to cervical cancer is more rare in European countries. This chapter analyses two cases of rare locations of tuberculosis (TB) in young Romanian women. The first patient presented a chronic primary TB breast abscess, non-pregnancy related with periods of apparent healing and repeated areolar fistula formation. In the second case, the unexpected discovery of secondary TB endocervical granulomatous inflammation with caseous necrosis on a radical hysterectomy specimen, performed after chemoradiotherapy for squamous non-keratinizing cell carcinoma is presented. Worldwide incidence, risk factors, hypothetic mechanisms of primary/secondary breast and cervix uteri MbT infection, the association to high-risk HPV, microbiological diagnosis difficulties, the differentials to pyogenic abscesses, other chronic granulomas and breast cancer treatment issues are presented in the reviewed literature, focusing on the peculiarities of these rare locations and complications. It is recalled an old concept of “therapeutic antitubercular” test when all other assessments steps are usefulness.
Part of the book: Tuberculosis