The previous cesarean section is an important risk factor for the development of placental complications.

Endomterial-subendometerial blood flow distribution pattern assessed by transvaginal color Doppler, as well as good flow in uterine vessels, are necessery for good pregnancy rates. Thin endomterium, undetectable subendomterial blood flow and higher uterine arterial resistance, were associated with low pregnancy rate and poor outcome.

<zakljucak> Pri donosenju odluke o lecenju bolesnice sa karcinomom endometrijuma znacajno je: 1) da li je bolest u odmaklom stadijumu ili je prisutan recidiv tumora, 2) da li je prethodno sprovedena terapija i ako jeste, koji vid terapije (zracenje ili hemioterapija), 3) da li je tumor merljiv ili nemerljiv i 4) o kom se histoloskom tipu tumora radi. Kod pojave recidiva znacajno je da li se on javio u prethodno zracenom polju ili van njega. Treba imati u vidu da je prezivljavanje bolesnica sa odmaklim i recidivirajucim karcinomom endometrijuma oko jedne godine i da su dosadasnji protokoli pokazali manje ili vise izrazenu toksicnost. S tog aspekta, vazno je i da primenjena terapija ne izazove znacajno oboljenje i narusavanje kvaliteta zivota bolesnice. Terapija uznapredovalog, metastatskog i recidivirajuceg karcinoma endometrijuma zahteva individualni pristup u zavisnosti od zivotne dobi i opsteg stanja bolesnice, mesta recidiva i prethodno sprovedene terapije. Pored hemioterapije, terapijske mogucnosti koje su na raspolaganju za sada su palijativna hirurgija i radioterapija, kao i hormonska terapija. .

The aim of this paper was to present the role of human papillomavirus (HPV) in cervical carcinogenesis from several aspects. By explaining the HPV virus lifecycle and structure, its effect on cervical cell cycle and subversion of immune response can be better understood. Early E region of the viral genome encodes proteins that are directly involved in carcinogenesis. The E6 protein binds to p53 protein (product of tumor-suppressor gene) blocking and degrading it, which in turn prevents cell cycle arrest and apoptosis induction. E6 is also capable of telomerase activation, which leads to cell immortalization; it also reacts with host proto-oncogene c-jun, responsible for transcription, shortens G1 phase and speeds up the transition from G1 to S phase of the cells infected by HPV. E7 forms bonds with retinoblastoma protein (product of tumor-suppressor gene) and inactivates it. It can inactivate cyclin inhibitors p21, p27, and abrogate the mitotic spindle checkpoint with the loss of protective effect of pRB and p53. The immune system cannot initiate early immunological reaction since the virus is non-lytic, while the concentration of viral proteins--antigens is low and has a basal intracellular position. Presentation through Langerhans cells (LC) is weak, because the number of these cells is low due to the effect of HPV. E7 HPV reduces the expression of E-cadherin, which is responsible for LC adhesion to HPV-transformed keratinocytes. Based on these considerations, it may be concluded that the process of cervical carcinogenesis includes viral, genetic, cellular, molecular-biological, endocrine, exocrine and immunological factors.

Introduction: Endometrial carcinoma is diagnosed by histopathological assessment of the sampled endometrium. After establishing the diagnosis the patient needs to be further evaluated in order to establish an optimal treatment. The most important factors that determine the treatment plan include: age, reproduction status, the depth of myometrial invasion, cervical invasion, histopahological type of tumor, histological and nuclear grade. Surgery is the most common treatment. The choice of optimal surgical procedure may include various imaging methods.Aim of the study: Testing the usefulness of applying the ultrasound diagnostics in preoperative evaluation of patients diagnosed with endometrial carcinoma.Method: The prospective study included 61 patients diagnosed with endometrial carcinoma. The ultrasound was used to estimate the presence and depth of invasion of the uterine muscle and cervical inclusion. The obtained parameters were compared to histopathological findings from surgically removed uterus. Results:The sensitivity of the ultrasound method in the estimation of myometrial invasion in the tested sample was 77.59%, specificity was 100.00%, predictive value of the positive test was 79.03%. The sensitivity of the ultrasound method in the estimation of cervical invasion in the tested sample was only 11.11%, specificity was 90.91%, predictive value of the positive test was 33.33%, predictive value of the negative test was 71.43%, whereas total accuracy of the method was 67.74%.Conclusion: Ultrasound diagnostics can be used in the assessment of the depth myometrial invasion but not in the assessment of cervical inclusion.