Factors associated with adolescent substance use include social background, family, school and peers. Such associations could help to focus on better measures to eliminate or reduce the risk of substance use.

Our data show a risk of parametrial spread of 0.45% for tumors less than 20 mm in diameter, no LVSI, and a depth of invasion within the inner third. Patients wanting fertility preservation might be prepared to take this risk of recurrence. Morbidity after nerve-sparing radical hysterectomy is tolerably low, and for patients in whom fertility preservation is not an issue, this should be considered the standard of care.

2022-RA-1601-ESGO Figure 2 Conclusion TVS is in a very good agreement with MRI in detection of parametrial invasion.

Background/Aim. Hypoxia is one of the major changes that occurs in the tumor microenvironment. It has been observed that there are pluripotent cancer cells in the cancer cell population that affect tumor growth and their resistance to therapy. The aim of this study was to examine the expression of hypoxia-inducible factor-1 alpha (HIF-1α), endogenous marker of hypoxia, and SOX2, marker of the pluripotent stem cells existing in the normal adult tissues, in the cervical squamous cell carcinoma (SCC). Methods. The study was conducted in 90 women with invasive cervical SCC, divided into two groups-60 women in the Group A, with FIGO IB1 < 20 mm tumors (no metastases in the lymph nodes), and 30 women in the group B with tumors FIGO I-II (positive lymph nodes). The basic clinical parameters were determined by standard histopathological analysis, and the expression of HIF-1α and SOX2 by immunohistochemical examination. Results. There was a significant difference between the groups A and B, in the expression of HIF-1α (p = 0.024), but not in the expression of SOX2 (p = 0.566). Expression of HIF-1α was significantly higher in the group with lymph node metastases and invasion of lymphovascular spaces (p <0.001) but not associated with tumor size (p = 0.291) or lymphocytic stromal response (p = 0.940). The tumor grade significantly influenced the expression of HIF-1α (p = 0.013). The expression of SOX2 did not significantly correlate with any of the established clinical tumor parameters. Conclusion. A significant difference in the expression of HIF-1 α between the group with and that without metastases in lymph nodes in invasive cervical SCC could distinguish HIF-1α as a parameter of poor prognosis of the disease. The prognostic significance of SOX2 as well as a significant correlation between expression of HIF-1α and SOX2 were not established.

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