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The use of IHC marker p16 in HPV lesions of the cervix
ILOVIČNÁ, Kristýna
HPV is one of the most common sexually transmitted diseases. It mostly spreads by sexual way, less often orally, by contaminated fingers or by beddings. Another ways of transmission are from the mother to the fetus at birth or transplacentarly. It usually occurs in young women aged 20 to 25 years and approximately 80% of sexually active individuals have experience with it during their life. Human papillomavirus is an infectious agent associated with a specific type of human cancer and it occurs in 99,7 % of all cervical cancers. More than one hundred papillomaviruses have been identified so far, we can divided them into the lowrisk and the highrisk groups. One of the best possible ways to reduce the risk of a disease is to keep a sexual relationship with only one partner. But the partner can also be carrier of the infection without revealing any symptoms. Preventive measures also include regular gynecologycal examinations. The incidence of cervical cancer has significantly decreased in many developed countries, mainly due to cytological screening programmes. The disease could be detected in the early stages, when the possibilities of successful treatment are noticeably higher. There are three standard procedures in the treatment of cervical cancer - surgery, radiotherapy and chemotherapy. In the practical part, I compare the positivity of the p16 marker between each histological groups by using light microscope NIKON Eclipse E400. The use of p16 immunohistochmically stained tissue improves total diagnostic accuracy. In this way 173 samples were examined at the Departement of Pathology Nemocnice Písek a.s. during years 2016 and 2017. We divided them, according to stage of severity, into 34 low-grade lesions and 139 highrisk lesions. 18 of the lowrisk lesions and 130 highgrade lesions expressed p16 positivity. Staining of remaining slides was negative.
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Brachytherapy of gynaecological malignant tumor
KURÁŽOVÁ, Kristýna
The topic of this bachelor thesis is brachytherapy of gynaecological malignancy. In the theoretical part, the anatomy of female sex organs, general principles of brachytherapy, gynaecological applications of brachytherapy and malignant gynaecological diseases treated by this method, are described. The theoretical part is elaborated out of scientific publications, articles and web pages, in the form of literary research. The output of this research is the summary of knowledge about brachytherapy of gynaecological malignancy and thus, the creation of educational text, which was the primary objective of this thesis. Secondary objective of the thesis was to compare doses to the critical organs the bladder and the rectum, during the uterovaginal applications, depending on the type of the used applicator the Fletcher applicator and the Ring applicator. The data for the practical part were obtained from the archived radiation protocols of the oncological department of the Hospital České Budějovice a.s. and then the data were carried out in to charts. Two units of patients, treated for cervical carcinoma by uterovaginal application in years 2008 2018, were compared. The results indicate that the average doses to the bladder are almost identical for both applicators, but the doses are lower by 0,09 Gy for the Fletcher applicator, than for the Ring applicator. The average dose to rectum is, however, lower by 1,136 Gy while using the Ring applicator. That suggests that using of the Ring applicator during uterovaginal application is more advantageous for saving the rectum, considering the applied radiation dose. The initial hypothesis that for using the newer Ring applicator the doses to the critical organs are lower, then for the Fletcher applicator, was neither confirmed nor rejected, according to the results obtained.
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Radiotherapy of cervical cancer
KUBIŠOVÁ, Lucie
This bacherol thesis focuses on radiotherapy of cervical cancer. In the theorical part we describe the anatomy proportions of little pelvis, typology of the tumor, its occurance, risk factors that can cause this disease, symptoms and diagnostics. We put special attention on the questions related to the prevention of cervical carcinoma. In addition we are interested in the treatment for this malignant disease surgery solutions, teletherapy, brachytherapy and chemotherapy. The second part of the bacherol thesis is empirical and focuses the radiotherapeutical treatment of patients with cervical carcinoma, stressing the analysis of doses of irradiation for the critical organs with repercussion for posterior occurance of acute or late undesired effects. The major risk factor detected was the insufficient participation of the respondents on the preventive gynecology examinations. The collected data reflect that only one third of women are undergoing the regular screening by their doctors. When analyzing the facts, we wanted to focuse on the irradiation doses applied to the critical organs. The obtained results showed that neither doses nor fractions have demostrated even a little progress during seven years. At the same time the techniques of irradiation did not evolve very much during the same period. The only difference was the increase of application of the IMRT technique in 2017 in comparison to 2010. The original hypothesis of the thesis advocating that the improvement of verification systems, imaging machines and planning systems could have an impact on the reduction of undesired effects caused by irradiation of critical organs during radiotherapy of cervix, was rejected due to above mentioned results.
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Occurrence of woman cervical cancer in South Bohemian Region.
NĚMCOVÁ, Eva
Cervical cancer represents an enormous health, psychological and social stress for every woman. The most important risk factor in the development of cervical carcinoma, which the second most common malignant cancer in women, is infection with a high-risk strain of human papillomavirus - a very frequent sexually transmitted disease. More than 100 types of HPV are acknowledged to exist, with HPV 16 and 18 being classified as high-risk types in particular. Worldwide, 500,000 new cases of cervical cancer are diagnosed every year. In the Czech Republic, there are 1,000 new cases of cervical cancer each year, out of which up to 400 women die. It is estimated that there will be up to 1,000,000 new cases of cervical cancer by 2050 unless the prevention is improved. Every woman is at risk of developing cervical cancer. HPV is sexually transmitted, however not only by sexual intercourse but also by skin-to-skin-contact with infected areas. Other risk factors in the development of the disease are: first sexual intercourse at early age, the number of sexual partners, smoking, other sexually transmitted diseases and a long term use of hormonal contraception. Use of condoms, which protects against sexually transmitted diseases, reduces the transmission of HPV by up to 70%. Having regular gynaecological check-ups with Pap smears is crucial for cervical cancer screening, as the screening suggests the presence of cytological abnormalities and pre-cancer. However, it cannot detect all types of premalignant changes and early stages of the carcinoma. Two vaccines have recently been developed, effective against the most frequent oncogenic strains of HPV (16 and 18), which currently cause about 70% of cervical cancer cases. Active immunisation against human papillomavirus is the first vaccination against carcinoma. Together with screening, it represents the best prevention method against cervical carcinoma. Based on the research of technical literature, the first part of the dissertation gives an overall view of the issue of cervical carcinoma. The second part of the dissertation deals with the research, eliciting the knowledge and attitude of women from Southern Bohemian towns in the field of cervical carcinoma prevention in the period of December 2008 - March 2009 and comparing it to technical literature.
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HOW EDUCATION AFFECTS WOMEN IN THE VYSOČINA REGION TO USE A POSSIBILITY OF CERVICAL CANCER VACCINATION
ŠIDLÁKOVÁ, Lenka
The bachelor´s work captures a level of knowledge of present-day girls and young women about cervical cancer. It shows their attitude towards the possibility of cervical cancer vaccination, if they know the fees, a number of doses, risk factors etc. The work is divided into two parts, a theoretical and a practical ones. The theoretical part describes the current status-the anatomy of female reproductive organs, the history, occurence, causes, transmission, symptoms, diagnoses, possibilities of treatment and mainly prevention. The practical part contains targets and hypotheses, methods, results of the research that are transferred into the graphs. The practical part also includes a discussion where the results, obtained through my own research, are thought about. The results are further compared with similar conclusions of other authors. All is completed by my own opinion.
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Toxic effects of Radiotherapy for Female Patients over 60 Years of Age with Gynecological Tumors
POLODNOVÁ, Šárka
Cervical cancer and cancer within the body of the uterus are the most frequent cancers of the female reproductive organs, the incidence of which is on the rise. Every year, more than 1,000 new cases of cervical cancer are diagnosed in the Czech Republic, as well as 1,500 cases of endometrial cancer. Surgical treatment and external radiotherapy are used during therapy and, in some cases, it is combined with brachytherapy and chemotherapy. I focused on the early toxicity of radiotherapy, which can be a limiting factor for the completion of treatment, especially in older patients. The investigated sample consists of 100 female patients who were divided into 4 groups, according to age and the primary diagnosis of these patients. Each group consists of 25 women. Patients in the first group are represented in a group of those under 60 years of age with cervical cancer; the average age is 48 years. The second group consists of patients with the same diagnosis, but who are over 60 years of age; the average age is 66 years. The third group consists of patients who are under 60 years of age who have uterine cancer; the average age is 54 years. The 4th group consists of patients who are over 60 years of age with uterine cancer; the average age is 71 years. All patients were irradiated at the Oncological Clinic of České Budějovice Hospital. In my thesis, I compared the toxicity of radiotherapy in the group of younger patients with the group of the older patients. Hematological toxicity was more frequently identified in older patients, be it the malignant cervical cancer (76%) or the endometrial cancer (52%). In younger patients, hematological complications occurred less frequently (cervix {--} 52%, body of uterus {--} 24%). Serious grade 4 toxicity was identified in one patient over 60 years of age with separate pelvis radiotherapy for cervical cancer. Grade 3 toxicity was identified in one patient from the younger group and in one patient from the older group with combined treatment for cervical cancer. In regard to non-hematological complications, toxicity was more severe in older patients too. The incidence of diarrhea in the over 60-year-olds was 64% as opposed to 48% in the younger group. The stated hypothesis of higher toxicity of treatment for older patients was confirmed during my research.
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