Faculty of Medicine
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Item type:Publication, NGAL and HPV Subtypes in Cervical Carcinoma: Implications for Cancer Progression and Treatment Response(MDPI AG, 2026-02-23); ; Background/Objectives: Cervical cancer is a prominent source of morbidity and mortality among women, particularly in low- and middle-income nations. Neutrophil Gelatinase-Associated Lipocalin (NGAL), a glycoprotein involved in cancer-related activities, has been proposed as a biomarker; however, its involvement in cervical cancer remains unknown. The study aim is to evaluate the prognostic significance of serum NGAL levels in cervical cancer patients in relation to International Federation of Gynecology and Obstetrics (FIGO) stage, operability, and HPV subtype distribution before and after treatment. Methods: The study involved 130 women, 100 with histologically proven cervical cancer and 30 healthy controls. The serum NGAL levels were determined before and after treatment using an ELISA test. HPV genotyping was carried out using real-time PCR on 21 high- and low-risk subtypes. Results: NGAL levels increased marginally during therapy (from 134 to 144 ng/mL; p = 0.28), but the rise was significant in inoperable patients (p = 0.02) and increased with advanced FIGO stage, although this did not reach statistical significance (p = 0.07). HPV 16 was the most common subtype (26.0%), while women aged 51–60 had the highest overall HPV positive rate (72.7%). There was no significant association between NGAL levels and HPV subtypes (p = 0.17). Conclusion: NGAL does not appear to be an accurate short-term indicator of therapy response. However, increased levels in advanced-stage and inoperable instances indicate prognostic significance. NGAL most likely represents tumor-associated inflammation rather than HPV subtype. These findings support its possible inclusion in future biomarker panels, subject to validation in bigger investigations. Persistent HPV infection in midlife women highlights the significance of ongoing screening.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EVALUATION OF THE HISTOPATHOLOGICAL PROFILE OF CERVICAL BIOPSIES(Македонска асоцијација на гинеколози и опстетричари = MACEDONIAN ASSSOCIATION OF GYNECOLOGISTS AND OBSTETRICIANS, 2025); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Association of IL-10 (rs1800872) and IL-4R (rs1805010) polymorphisms with cervical intraepithelial lesions and cervical carcinomas(BAKIS Productions LTD, 2020); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Association of TNF-a (rs361525 and rs1800629) with susceptibility to cervical intraepithelial lesion and cervical carcinoma in women from Republic of North Macedonia(Wiley-Blackwell Publishing Ltd., 2020); ; Cervical cancer (CCa) is one of the most common malign diseases in women associated with human papillomavirus (HPV). The virus is an initiating factor, but not sufficient for the development of cervical intraepithelial lesions (CIN) and CCa. The disease might be a result of the influence of host's genetic factors and polymorphisms in inflammatory-related genes that modify the immune response to HPV and attribute to cancer susceptibility. We carried out a study to determine the association between TNF-a-238G/A and TNF-a-308 G/T polymorphisms with HPV-positive CIN and CCa in women living in the Republic of North Macedonia. Using multiplex SNaPshot analysis for single nucleotide polymorphisms (SNPs), we analysed the genotype and allele distributions of TNF-a-238G/A and TNF-a-308 G/T in 134 cases (HPV-positive and histologically confirmed CIN and CCa) and in 113 controls (cytological and HPV-negative women). For further analysis, the case group was stratified in three subgroups (all cases: CINs+ CCa− group; CIN2+ -group and CIN1− group). Data analysed using the odds ratio (OR) and chi-square test showed the frequency of AA genotypes and A alleles are not significantly higher in cases compared to the controls for both SNPs: AA of TNF-a-238 (0.7% versus 0%) and TNF-a-308 (1.5% versus 0.9%) as well as A allelic frequency (3.0% versus 1.7%) and (13.1% versus 10.6), respectively. The comparison of the case's subgroups with the control group did not show a statistically significant difference. Compared to controls, TNF-a-238G/A and TNF-a-308 G/T are not associated with the risk of HPV associated CIN or CCa in the studied women. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SUCCOR quality: validation of ESGO quality indicators for surgical treatment of cervical cancer(2022-10-03) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Postoperative TNM classification of cervical cancer (1989-1995)(University of Niš Faculty of Medicine and the Department of the Serbian Medical Society Niš, 1996-06)The aim of this study is to present and analyze the results of the application of postoperative TNM classification of cervical cancer. For this purpose we have reviewed the clinical and histopathological data of 464 patients with cervical intraepithelial (74) and invasive cancer (390) who underwent abdominal hysterectomy or radical hysterectomy with regional lymphadenectomy from March 1989 to December 1995. There were 74 (16.0%) cases of Stage 0, 211 (45.5%) of Stage I, 88 (18.9%) of Stage II, 84 (18.1%) of Stage III and 7 (1.5) cases of Stage IV. In our case series (399) we have found significant rate of discordance between clinical FIGO and postoperative stadium. The incidence of error increases progressively as the stage grows more advanced, with prevalent understaging. Cross relationships of tumor extent, incidence of lymph node metastasis, grade of tumor differentiation, histological type, and age of the patients were also studied and are discussed. These data indicate that postoperative TNM classification staging system should be applied regularly, systematically and universally. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The role of magnetic resonance imaging in the preoperative staging of invasive cervical cancer(Medical Faculty, Ss Cyril and Methodius University in Skopje, 2014); ; Aim: To evaluate the diagnostic performance of magnetic resonance imaging (MRI) in the preoperative evaluation of patients with invasive cervical cancer, in terms of parametrial involvement, lymph node metastases and tumor size. Methods: The retrospective study included 48 patients with histologically verified invasive cervical cancer, treated surgically with radical hysterectomy and pelvic lymphadenectomy in the period January 2012 - December 2013. All patients had preoperative MRIs. The reference standard for comparison was the histopathological findings from the operative specimens. Results: Six patients in our study (12.5%) had parametrial involvement verified on histopathological analysis. MRI identified probable parametrial involvement in 8 (16.7%) patients. The sensitivity, specificity, positive predictive value and negative predictive value (PPV and NPV) of MRI in detecting parametrial involvement were 83.3%, 92.7%, 62.5% and 97.5%, respectively. Histopathological analysis of the operative specimens identified 11 (22.9%) patients with lymph node metastases. The MRI scans detected probable lymph node metastases in 15 (31.3%). The sensitivity, specificity, PPV and NPV of MRI in detecting lymph node metastases were 63.6%, 78.4%, 46.7% and 87.9%, respectively. MRI was better at estimating the tumor size (rs=0.67, p<0.001) when compared to clinical examination (rs=0.34, p<0.001). Conclusion: Preoperative MRI showed low PPV in detecting lymph node metastases and parametrial involvement. MRI was superior, compared to the clinical examination, in the estimation of tumor size. Further research is required to determine the cost-effectiveness of using MRI instead of conventional clinical staging tests. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The implementation of prognostic index and risk grouping in surgically treated cervical carcinoma patients: A prospective validation study(Македонско лекарско друштво = Macedonian medical association, 2013); Veljanoska-Petreska, SlavicaIntroduction. The objective of this prospective study was to validate the prognostic criteria defined by the results of our previous study in an independent population of surgically treated cervical carcinoma patients. Methods. The study group consisted of 340 patients who underwent abdominal hysterectomy with pelvic lymphadenectomy as primary therapy. Based on the scores of the variables (blood vessel invasion, lymph node metastases, tumor diameter, degree of inflammatory reaction at the invasive front, and minimum thickness of uninvolved cervical stroma/parametrial extension) and calculated prognostic index (PI) values, the patients were divided into three prognostic groups. Results. The 5-year disease-free survival (DFS) rates of the low, intermediate, and high-risk groups were 98,82%, 84,57%, and 74,01%, respectively. The differences in DFS rates were statistically significant (P<0,00001). In order to validate the model from our previous study, we have compared DFS rates between the groups. There was no difference in DFS rate between low-risk groups, although the majority of the patients in this study were not irradiated, while radiotherapy was administrated invariably to all the original study patients. Similarly, DFS did not differ significantly between the intermediate-risk groups, which could be expected since radiotherapy was administrated to majority of the patients in this study. In contrast, the high-risk group patients in this study had significantly higher DFS rate (74,01% vs. 44,24%, P=0,0010), probably as the result of the adjuvant chemotherapy administrated to 69% of them. Conclusions. PI could be a sound and reliable basis for appropriate planning of the following therapeutical strategy of the surgically treated cervical carcinoma patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ki-67 expression in the invasive front as an additional independent significant prognostic factor influencing recurrence in early stage cervical carcinomas.(Macedonian Association of Anatomists and Morphologists, 2009); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Impact of socio-demographic factors on the delayed diagnosis and advanced stage presentation of patients with invasive cervical cancer in Macedonia(Macedonian Academy of Sciences and Arts, 2013); ; Aim: The study aims to establish certain socio-demographic factors associated with delayed presentation (i.e. advanced stage at diagnosis) in patients with invasive cervical cancer in Macedonia.Materials and methods: The cross-sectional study was conducted with patients already diagnosed and treated for invasive cancer of the uterine cervix who came in for their regular annual check-up at the University Radiotherapy and Oncology Clinic, Medical Faculty, Ss. Cyril and MethodiusUniversity in Skopje, Macedonia. The data were collected by interviewing the participants using a standardized questionnaire. Results: A total of 115 patients were recruited in the study. Eight of them were excluded from further analysis due to incomplete data. Close to 72% of the patients analysed presented with advanced-stage disease, while 28.04% of the patients were diagnosed with early-stage disease. The univariate analysis and Chi-square statistics showed that the patients had a higher probability of being diagnosed with advanced-stage disease if they had a low monthly income (p = 0.01), had lower degrees of education (p < 0.001), had an unsatisfactory level of genital hygiene (p < 0.001) and had no family history of invasive cervical cancer in first-degree female relatives (p = 0.003).Discussion: The results from the study could be utilized to identify the population at risk which should be targeted for implementation of specialized educational programmes for familiarizing the population with the nature of the disease which in turn would increase the level of consciousness as a step towards implementing a national screening programme.