{"id":1208,"date":"2016-12-06T21:16:43","date_gmt":"2016-12-06T20:16:43","guid":{"rendered":"http:\/\/www.newslab.sk\/2016\/12\/06\/cintec-plus-nase-skusenosti\/"},"modified":"2017-10-04T09:24:45","modified_gmt":"2017-10-04T07:24:45","slug":"cintec-plus-our-experience","status":"publish","type":"post","link":"https:\/\/www.newslab.sk\/en\/cintec-plus-our-experience\/","title":{"rendered":"CINtec PLUS- our experience"},"content":{"rendered":"
*All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf\u00a0<\/strong><\/span>\r\n attachment at the end of the paper.<\/strong><\/span><\/pre>\n
 <\/p>\n
Karcin\u00f3m kr\u010dka maternice tvor\u00ed druh\u00fa naj\u010dastej\u0161iu rakovinu u \u017eien vo svete i na Slovensku. V etiol\u00f3gii vzniku ochorenia zohr\u00e1va rozhoduj\u00facu \u00falohu pretrv\u00e1vaj\u00faca infekcia vysoko rizikov\u00fdmi typmi \u013eudsk\u00e9ho papilomav\u00edrusu (HR HPV).<\/p>\n
V\u010dastn\u00e1 detekcia pred rakovinov\u00fdch \u0161t\u00e1di\u00ed ochorenia, tzv. dyspl\u00e1zi\u00ed (skvam\u00f3znych a glandul\u00e1rnych) m\u00f4\u017ee z\u00e1sadn\u00fdm sp\u00f4sobom redukova\u0165 v\u00fdskyt rozvinut\u00fdch foriem tohto ochorenia a zn\u00ed\u017ei\u0165 tak mortalitu. Cytologick\u00e1 diagnostika m\u00e1 preto nezastupite\u013en\u00fa \u00falohu v diagnostike tohto ochorenia.<\/p>\n
Skr\u00edning rakoviny kr\u010dka maternice pon\u00faka dve mo\u017enosti vy\u0161etrenia:<\/p>\n
    \n
  1. Cytologick\u00fd test, ktor\u00fd je zalo\u017een\u00fd na mikroskopickom zhodnoten\u00ed morfol\u00f3gie buniek, \u010do je pomerne lacn\u00e1, senzit\u00edvna a \u0161pecifick\u00e1 met\u00f3da, av\u0161ak m\u00e1 svoje limity.<\/em><\/li>\n<\/ol>\n
    V s\u00fa\u010dastnosti m\u00e1me dve mo\u017enosti vy\u0161etrenia v cytol\u00f3gii steru z kr\u010dka maternice. Klasick\u00fa tzv. konven\u010dn\u00fa cytol\u00f3giu, kde sa ster odobrat\u00fd z kr\u010dka maternice natrie na podlo\u017en\u00e9 skl\u00ed\u010dko, zafarb\u00ed sa a n\u00e1sledne ho cytol\u00f3g vyhodnot\u00ed vo svetelnom mikroskope. Liquid-based cytol\u00f3giu (LBC), kde sa ster odobrat\u00fd z kr\u010dka maternice odoberie do \u0161peci\u00e1lneho m\u00e9dia vo vyj\u00e1lke a n\u00e1sledne spracov\u00e1va v laborat\u00f3riu. LBC pon\u00faka na rozdiel od konven\u010dnej cytol\u00f3gie viac mo\u017enost\u00ed ako len morfologick\u00e9 vyhodnotenie, medzi ktor\u00e9 patria HPV testy, vy\u0161etrenie na chlam\u00fddie a neisseria gonorrhoea, pr\u00edpadne stanovenie in\u00fdch molekul\u00e1rnych markerov. Detekcia \u013eahk\u00fdch a \u0165a\u017ek\u00fdch stup\u0148ov skvam\u00f3znych intraepiteli\u00e1lnych l\u00e9zi\u00ed je v LBC signifikantne efekt\u00edvnej\u0161ia pre vy\u0161\u0161iu kvalitu vzoriek a mo\u017enos\u0165 imunohistochemick\u00e9ho vy\u0161etrenia du\u00e1lnou protil\u00e1tkou Ki67 a p16.<\/p>\n
      \n
    1. Genetick\u00e9 vy\u0161etrenie steru na HR-HPV, kde sa stret\u00e1vame s vysokou prevalenciou najm\u00e4 u mlad\u00fdch \u017eien, z ktor\u00fdch v\u00e4\u010d\u0161ina infekciu spont\u00e1nne eliminuje, t\u00e1to met\u00f3da je v\u0161ak finan\u010dne n\u00e1ro\u010dnej\u0161ia.<\/em><\/li>\n<\/ol>\n
       <\/p>\n
      Imunohistochemick\u00e9 vy\u0161etrenie du\u00e1lnou protil\u00e1tkou p16 a Ki67.<\/strong><\/p>\n
      Prote\u00edn p16 INK4 hr\u00e1 k\u013e\u00fa\u010dov\u00fa \u00falohu v regul\u00e1cii G1-S prechodu v bunkovom cykle. Over-expresia tohto prote\u00ednu je priamo spojen\u00e1 s onkog\u00e9nnou transform\u00e1ciou cervik\u00e1lnych buniek.<\/p>\n
      Ki67 je labiln\u00fd non-hist\u00f3nov\u00fd nukle\u00e1rny prote\u00edn prolifera\u010dne akt\u00edvnych buniek. Detekciou p16 a Ki67 imunohistochemick\u00fdm farben\u00edm du\u00e1lnou protil\u00e1tkou sa zvy\u0161uje z\u00e1chyt z\u00e1va\u017en\u00fdch foriem skvam\u00f3znych intraepitelov\u00fdch l\u00e9zi\u00ed.<\/p>\n
      V na\u0161om laborat\u00f3riu sme previedli anal\u00fdzu spolu 81 vy\u0161etren\u00ed, kde sme evidovali od jednej pacientky cytologick\u00e9 vy\u0161etrenie a n\u00e1sledne aj bioptick\u00e9 vy\u0161etrenie kr\u010dka maternice.<\/p>\n
      V\u00fdsledky anal\u00fdzy:<\/em><\/p>\n
        \n
      • 16 pacientiek s cytologick\u00fdm z\u00e1verom ASUC, z nich v\u0161etky boli imunohistochemicky p16\/Ki67 negat\u00edvne a n\u00e1sledne v bioptickom vy\u0161etren\u00ed boli bez verifikovanej cervik\u00e1lnej intraepitelovej neopl\u00e1zie alebo s \u013eahk\u00fdm stup\u0148om cervik\u00e1lnej intraepitelovej neopl\u00e1zie (CIN I).<\/li>\n
      • 17 pacientok s cytologick\u00fdm z\u00e1verom ASC-H, z nich 16 bolo imunohistochemicky p16\/Ki67 pozit\u00edvnych a n\u00e1sledne v bioptickom vy\u0161etren\u00ed bolo 14 z nich verifikovan\u00fdch ako stredne \u0165a\u017ek\u00e1 a\u017e \u0165a\u017ek\u00e1 cervik\u00e1lna intraepitelov\u00e1 neopl\u00e1zia (CIN II-III), 1 pacientka ako \u013eahk\u00e1 cervik\u00e1lna intraepitelov\u00e1 neopl\u00e1zia (CIN I) a jedna pacientka bola bez dyspl\u00e1zie.<\/li>\n
      • 39 pacientiek s cytologick\u00fdm z\u00e1verom LSIL, z nich bolo 7 imunohistochemicky p16\/Ki67 pozit\u00edvnych a n\u00e1sledne u v\u0161etk\u00fdch siedmych bola biopticky verifikovan\u00e1 stredne \u0165a\u017ek\u00e1 a\u017e \u0165a\u017ek\u00e1 cervik\u00e1lna intraepitelov\u00e1 neopl\u00e1zia (CIN II-III).<\/li>\n
      • 9 pacientiek s cytologick\u00fdm z\u00e1verom HSIL z nich boli v\u0161etky imunohistochemicky p16\/Ki67 pozit\u00edvne a u v\u0161etk\u00fdch bola biopticky verifikovan\u00e1 stredne \u0165a\u017ek\u00e1 a\u017e \u0165a\u017ek\u00e1 cervik\u00e1lna intraepitelov\u00e1 neopl\u00e1zia (CIN II-III).<\/li>\n<\/ul>\n
         <\/p>\n
        \"hsil-p16ki67\"\u00a0\u00a0\"hsil-cin-iii-p16-ki-67-_1\"<\/p>\n
        \"hsil-cin-iii-p16-ki-67-_2\"\u00a0\"hsil-cin-iii-p16-ki-67-_3\"<\/p>\n
        \"p16ki67\"<\/p>\n
        Z\u00e1ver<\/strong><\/p>\n
        Imunohistochemick\u00e9 vy\u0161etrenie LBC pomocou du\u00e1lnej protil\u00e1tky CINtec PLUS p16\/Ki67 n\u00e1m pon\u00faka lep\u0161ie odhadnutie rizika mo\u017en\u00e9ho vzniku n\u00e1dorovej prolifer\u00e1cie skvam\u00f3zneho epitelu kr\u010dka maternice. Kombin\u00e1cia dvoch markerov p16 a Ki67 sa zd\u00e1 by\u0165 u\u017eito\u010dn\u00fdm pomocn\u00edkom pri diagnostike high-grade dysplastick\u00fdch l\u00e9zi\u00ed s mo\u017en\u00fdm potenci\u00e1lom mal\u00edgnej transform\u00e1cie. Pozitivita imunohistochemick\u00e9ho vy\u0161etrenia n\u00e1s nab\u00e1da k nevyhnutn\u00e9mu doplneniu genetick\u00fdm vy\u0161etren\u00edm na HR HPV (mRNA E6\/E 7) a t\u00fdm napom\u00e1ha k zlep\u0161eniu celkov\u00e9ho mana\u017ementu pacientky.<\/p>\n
         <\/p>\n
        Literat\u00fara<\/strong><\/p>\n
          \n
        1. DeMAY RICHARD. The Pap Test. <\/i>Singapore: American Society for Clinical Pathology, 2005. 352 s. ISBN 0-89189-420-9.<\/li>\n<\/ol>\n
          2. HOR\u00c1\u010cEK, JAROSLAV \u2013 KOBILKOV\u00c1, JITKA. Gynekologick\u00e1 cytodiagnostika. <\/i>Praha: Maxdorf Jessenius, <\/i>2013. \u00a0 \u00a0 136 s. ISBN 978-80-7345-327-5.<\/p>\n
          3. SOLOMON, DIANE \u2013 NAYAR, RITU. The Bethesda System for Reporting Cervical Cytology. <\/i>Second Edition. \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 China: Springer, 2004. 191 s. ISBN 0-387-40358-2.<\/p>\n","protected":false},"excerpt":{"rendered":"
          *All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf\u00a0 attachment at the end of the paper.   Karcin\u00f3m kr\u010dka maternice tvor\u00ed druh\u00fa naj\u010dastej\u0161iu rakovinu u \u017eien vo svete i na Slovensku. V etiol\u00f3gii vzniku ochorenia zohr\u00e1va rozhoduj\u00facu \u00falohu pretrv\u00e1vaj\u00faca infekcia vysoko rizikov\u00fdmi typmi \u013eudsk\u00e9ho papilomav\u00edrusu (HR<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"footnotes":""},"categories":[293],"tags":[752,750,751,749,748],"class_list":["post-1208","post","type-post","status-publish","format-standard","hentry","category-cytology","tag-analysis","tag-cintec-plus-dual-antibody","tag-dysplasia","tag-immunocytochemistry","tag-liquid-based-cytology-lbc","typ_clanku-casuistry"],"acf":{"abstrakt":"
          Cervical cancer belongs among the most frequent oncological diseases in Slovakia. Cytological diagnosis has an irreplaceable role in early detection of precancerous stages. Apart from the so-called conventional cytology, LBC offers more efficient detection of mild and severe dysplasia, moreover, it offers the possibility of immuno-histochemical examination with Ki67 and p16 dual antibody. We performed analysis of 81 examinations, where we registered cytological test and subsequent biopsy of cervix per patient. The results have shown that LBC test by way of dual antibody offers better risk estimate of the potential cancerous proliferation of squamous cervical epithelia.<\/p>\n
          Key words:<\/strong> Liquid-based cytology (LBC), immunocytochemistry, CINtec PLUS dual antibody, dysplasia, analysis.<\/p>\n","casopis":[{"ID":1000,"post_author":"7","post_date":"2015-11-21 14:33:24","post_date_gmt":"2015-11-21 13:33:24","post_content":"
          GENETICS<\/strong><\/h4>\r\n
            \r\n \t
          • The laboratory age<\/li>\r\n \t
          • The Odyssey of DNA reading<\/li>\r\n \t
          • Comparative genomic hybridisation: a methodological introduction<\/li>\r\n \t
          • Next generation sequencing and its application in clinical genetics<\/li>\r\n<\/ul>\r\n
            <\/h4>\r\n
            BIOCHEMISTRY<\/strong><\/h4>\r\n
              \r\n \t
            • Determining of the trace elements in blood serum<\/li>\r\n \t
            • Determining of \u03b1-tocopherol (vitamin E) in serum by way of liquid chromatography with tandem mass spectrometry (LC\/MS\/MS)<\/li>\r\n \t
            • Analysis of urinary calculi and its path to Europe<\/li>\r\n<\/ul>\r\n \r\n
              IMMUNOLOGY <\/strong><\/h4>\r\n
                \r\n \t
              • New autoantibodies in diagnosis of autoimmunity myopathies<\/li>\r\n \t
              • Taking advantage of flow-based cytometry in determining prognostic markers<\/li>\r\n<\/ul>\r\nCD38 and ZAP-70 in patients with B-CLL\r\n\r\n \r\n
                CYTOLOGY AND PATHOLOGY <\/strong><\/h4>\r\n
                  \r\n \t
                • Mucinous ovarian carcinoma \u2013 news in diagnosis from the pathologist\u2019s perspective<\/li>\r\n<\/ul>","post_title":"newsLab","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"newslab-12015","to_ping":"","pinged":"","post_modified":"2017-08-16 21:43:10","post_modified_gmt":"2017-08-16 19:43:10","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.newslab.sk\/casopis\/newslab-12015\/","menu_order":0,"post_type":"casopis","post_mime_type":"","comment_count":"0","filter":"raw"}],"strana":"45","upload_clanok":{"ID":1209,"id":1209,"title":"medirex_1_2015-duricova","filename":"MEDIREX_1_2015-\u2013-Duricova.pdf","filesize":123365,"url":"https:\/\/www.newslab.sk\/wp-content\/uploads\/2016\/12\/MEDIREX_1_2015-\u2013-Duricova.pdf","link":"https:\/\/www.newslab.sk\/en\/cintec-plus-our-experience\/medirex_1_2015-duricova\/","alt":"","author":"7","description":"","caption":"","name":"medirex_1_2015-duricova","status":"inherit","uploaded_to":1208,"date":"2016-12-06 20:06:05","modified":"2016-12-06 20:06:05","menu_order":0,"mime_type":"application\/pdf","type":"application","subtype":"pdf","icon":"https:\/\/www.newslab.sk\/wp-includes\/images\/media\/document.png"}},"_links":{"self":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1208","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/comments?post=1208"}],"version-history":[{"count":0,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1208\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/media?parent=1208"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/categories?post=1208"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/tags?post=1208"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}