Cervical cancer related to human papillomavirus(HPV)is a leading cause of cancer-related mortality among women worldwide.Cancer cells release fragments of their DNA,known as circulating tumor DNA(ctDNA),which can be d...Cervical cancer related to human papillomavirus(HPV)is a leading cause of cancer-related mortality among women worldwide.Cancer cells release fragments of their DNA,known as circulating tumor DNA(ctDNA),which can be detected in bodily fluids.A PubMed search using the terms“ctHPV”or“circulating tumor DNA”and“cervical cancer”,limited to the past ten years,identified 104 articles,complemented by hand-searching for literature addressing medico-legal implications.Studies were evaluated for relevance and methodological quality.Detection and characterization of circulating tumor HPV DNA(ctHPV DNA)have emerged as promising tools for assessing prognosis and disease recurrence in cervical cancer.Detection techniques include polymerase chain reaction(PCR),digital droplet PCR(ddPCR),and next-generation sequencing(NGS).This review summarizes current knowledge on ctHPV DNA in cervical cancer and explores its clinical and medico-legal implications,including management of discordant results,diagnostic errors,liability,and data protection compliance.展开更多
Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical ca...Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.展开更多
This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in...This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in quality of life can significantly impact patients’lives.Currently,most treatments are supportive,with no specific treatment options available in Western medicine.Non-Western medicine,often less toxic and easier to administer,has shown promising results when used alongside radiotherapy for cervical cancer.Despite these potential benefits,challenges such as limited evidence and restricted application areas persist.While non-Western medicines may offer potential improvements in chemoradiotherapy outcomes for cervical cancer,further research is necessary to substantiate these benefits.展开更多
BACKGROUND Cervical cancer is a formidable global health issue,particularly affecting women in lower-middle-income countries with little or no access to preventative vaccines,screening programs,and treatment modalitie...BACKGROUND Cervical cancer is a formidable global health issue,particularly affecting women in lower-middle-income countries with little or no access to preventative vaccines,screening programs,and treatment modalities.The case report presents a unique case of a large cervical cancer achieving complete response(CR)with concurrent chemoradiotherapy(CCRT),highlighting the effectiveness of this treatment approach even in advanced stages and underscoring the importance of adaptive radiotherapy(RT)in optimizing patient outcomes.CASE SUMMARY We present the case of a 53-year-old woman who presented with four years of abnormal vaginal bleeding and was found to have p16-positive,moderately differentiated cervical squamous cell carcinoma.The tumor measured 14 cm×12 cm×8 cm,the largest size reported in the literature to achieve CR with CCRT.Despite this monumental feat,the patient remained disease-free and is currently on follow-up for 2 years;however,she continued to suffer from substantial morbidity caused by a vesicovaginal fistula and hydronephrosis,underscoring the continuing impact of cervical cancer on quality of life.CONCLUSION In this case report,we highlight the effectiveness of CCRT in achieving CR,even in cases of bulky cervical cancer,with adaptive RT offering a customized strategy to improve patient outcomes.We also emphasize the necessity for multidisciplinary team discussions and highlight the need for strategies to mitigate treatment-related toxicities and long-term complications.展开更多
Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological bi...Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological biomarkers for acute spinal cord injury,few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy.This study involved 30 patients with degenerative cervical myelopathy(51.3±7.3 years old,12 women and 18 men),seven healthy controls(25.7±1.7 years old,one woman and six men),and nine patients with cervical spondylotic radiculopathy(51.9±8.6 years old,three women and six men).Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics.Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities.Using least absolute shrinkage and selection operator analysis,we constructed a five-gene model(TBCD,TPM2,PNKD,EIF4G2,and AP5Z1)to diagnose degenerative cervical myelopathy with an accuracy of 93.5%.One-gene models(TCAP and SDHA)identified mild and severe degenerative cervical myelopathy with accuracies of 83.3%and 76.7%,respectively.Signatures of two immune cell types(memory B cells and memory-activated CD4^(+)T cells)predicted levels of lesions in degenerative cervical myelopathy with 80%accuracy.Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.展开更多
Cervical cancer is the fourth most common cancer worldwide, accounting for 6.8% of new cancer cases and 8.1% of cancer-related deaths. About 85% of these deaths occurred in low- and middle-income countries. The aim of...Cervical cancer is the fourth most common cancer worldwide, accounting for 6.8% of new cancer cases and 8.1% of cancer-related deaths. About 85% of these deaths occurred in low- and middle-income countries. The aim of this study was to assess the frequency and distribution of the human papillomavirus (HPV) genotypes in women showing cytological abnormalities of the cervix at the Sourô SANOU University Hospital (CHUSS) in Bobo-Dioulasso, Burkina Faso. This is a descriptive study of women recruited at the CHUSS. The cervico-uterine smear examination was carried out at the CHUSS Anatomy and Pathology Department for cervical cancer screening. The data were collected from women with atypical cells on their cervico-uterine smear. Cervicovaginal samples were taken from consenting women and HPV genotyping was performed using the HPV Direct FLOW CHIP kit at CERBA. We obtained approval from the ethics committee. The data were analyzed using the SPSS 26 software. The results of the study showed that 67.79% of the participants were aged between 50 and 65, a group that is particularly vulnerable to persistent infection with high-risk oncogenic HPV genotypes. Of the women screened, 40.7% were HPV positive and 29.2% had multiple infections. The most common genotypes were HPV 35, followed by HPV 18, 52, 58 and 66. These data highlight the need for increased surveillance and targeted prevention strategies among this female population.展开更多
Background: Early research describing the concept of intensity-modulated conformal radiotherapy (IMRT) was based on 7 to 9 beams to reach an adequate level of modulation. Nevertheless, its implementation demands signi...Background: Early research describing the concept of intensity-modulated conformal radiotherapy (IMRT) was based on 7 to 9 beams to reach an adequate level of modulation. Nevertheless, its implementation demands significant resources. Our objective was to compare the compliance and homogeneity of target dose distribution between simplified IMRT and 3D-CRT in patients with cervical cancer and to assess the clinical value of simplified IMRT. Materials and Methods: From 2016 to 2017, 17 patients with stage IIB - IIIC cervical cancer were treated with external beam radiotherapy using simplified IMRT (12 cases) or 3DCRT (05 cases) and brachytherapy. Prior to radiotherapy, CT scans were conducted to delineate the target volume. The clinical target volume (CTV) included the uterus, primary tumor, supravaginal portion of the cervix, paracervical tissue, common iliac, internal and external iliac lymph nodes, obturator, and pre sacral lymph nodes, and the surrounding tissues. If the lower vagina was involved, the target volume included the whole vagina. The planning target volume (PTV) included the CTV with 1 cm anteriorly and 0.5 cm in all other directions. The PTV received 95% of 45 Gy (1.8 Gy/25 fraction). Dose-volume histogram, conformity index, homogeneity index, and treatment time per fraction were compared. Results: The 3D-CRT plan was more homogeneous than the simplified IMRT plan, while the simplified IMRT plan was more conformal. The volume of small bowels that received high-dose radiation significantly increased with simplified IMRT compared to 3D-CRT. Treatment time per fraction was 6 and 13 minutes for 3D-CRT and simplified IMRT, respectively. Conclusion: The simplified IMRT treatment plan is technically and dosimetrically acceptable and an alternative to the classic 3D-CRT plan for cervical cancer. It provides better dose distribution than 3D-CRT. However, the 3D-CRT treatment plan significantly reduced the overall treatment time per fraction.展开更多
Cervical cancer,a leading malignancy globally,poses a significant threat to women's health,with an estimated 604,000 new cases and 342,000 deaths reported in 2020^([1]).As cervical cancer is closely linked to huma...Cervical cancer,a leading malignancy globally,poses a significant threat to women's health,with an estimated 604,000 new cases and 342,000 deaths reported in 2020^([1]).As cervical cancer is closely linked to human papilloma virus(HPV)infection,early detection relies on HPV screening;however,late-stage prognosis remains poor,underscoring the need for novel diagnostic and therapeutic targets^([2]).展开更多
In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strat...In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strategies:human papillomavirus(HPV)vaccination,cervical cancer screening,and treatment of precancerous lesions and cancer.Subsequently,the WHO and its partners developed a global strategy to accelerate the reduction of cervical cancer incidence,with an ultimate goal of achieving elimination within the next century.This Global Strategy represents a formal international commitment and is anchored in the 90-70-90 targets to be achieved by 2030.In parallel,several countries have also set national commitments,such as Sweden's pledge to achieve elimination by 2027 and Australia's target of achieving elimination by 2035.展开更多
BACKGROUND The full implementation of the national two-child policy has presented significant challenges in ensuring the safety of pregnant women.AIM To investigate the effect of cervical balloon fluid volume on mater...BACKGROUND The full implementation of the national two-child policy has presented significant challenges in ensuring the safety of pregnant women.AIM To investigate the effect of cervical balloon fluid volume on maternal processes,maternal and infant outcomes,and anxiety during pregnancy.METHODS A total of 100 singleton term pregnancies with cervical maturity induction and anxiety were selected using a lottery method;50 women were included.Cervical balloons were used for all participants.In the control group,80 mL of fluid was injected into both balloons;in the observation group,80 and 100 mL were injected into the vaginal and cervical balloons,respectively.The two groups were compared for cervical maturity,labor duration,anxiety,maternal and infant outcomes,and effects on cervical ripening.RESULTS After treatment,the cervical maturity test(Bishop)score was significantly higher in the observation group(9.76±1.19)than in the control group(7.62±0.83),and the Hamilton Anxiety Scale score was lower in the observation group(7.32±0.85)than in the control group(13.05±1.12).The observation group showed higher rates of natural delivery and lower rates of cesarean section than the control group.The first and total stages of labor were shorter in the observation than in the control group;no significant differences were found in the second and third stages.The incidence of complications was lower in the observation group[1(2.00%)vs 9(18.00%)for complications;49(98.00%)vs 41(82.00%)for non-complications].CONCLUSION The selected fluid volumes to promote cervical maturity and induce labor stabilize maternal mood,increase the natural delivery rate,shorten labor,and improve maternal and infant outcomes.展开更多
As the 30th anniversary of the landmark Beijing Fourth World Conference on Women approaches,the forthcoming 2025 World Women's Summit in Beijing offers a timely platform to reaffirm commitments to women's well...As the 30th anniversary of the landmark Beijing Fourth World Conference on Women approaches,the forthcoming 2025 World Women's Summit in Beijing offers a timely platform to reaffirm commitments to women's well-being worldwide.In alignment with this milestone,Cancer Biology&Medicine is proud to present this special issue dedicated to accelerating the global elimination of cervical cancer.展开更多
Objective:To investigate the effects of arecoline on HPV-positive cervical cells and unveil its underlying mechanism in cervical carcinogenesis.Methods:The cytotoxicity of arecoline was determined and the effect of su...Objective:To investigate the effects of arecoline on HPV-positive cervical cells and unveil its underlying mechanism in cervical carcinogenesis.Methods:The cytotoxicity of arecoline was determined and the effect of subtoxic concentrations of arecoline on the expression of viral oncoproteins and transcriptional factors was examined in CaSki and SiHa cells.HPV16 promoter activity was evaluated in a plasmid containing HPV16 long control region(pGL3-HPV16LCR)-transfected cells.Cell proliferation,cell migration,and number of colonies were assessed by MTT,wound healing assay,and colony-forming assay,respectively.Results:Arecoline at 0.01μg/mL significantly upregulated HPV16 E6 and E7 oncoproteins in both CaSki and SiHa cells.It also upregulated the expression level of c-Fos and c-Jun mRNAs,and c-Myc protein in CaSki and SiHa cells.In addition,arecoline at subtoxic concentrations(0.0025 and 0.01μg/mL)significantly induced HPV16 promoter activity in pGL3-16LCR-transfected cells.It also promoted SiHa and CaSki cell proliferation,migration,and colony formation.Conclusions:Arecoline at subtoxic concentrations promotes the proliferation,migration,and colony formation of CaSki and SiHa cells via upregulation of c-Fos,c-Jun,c-Myc,and HPV16 E6 and E7 expressions.展开更多
BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia,accounting for 8.5%of all cancer-related deaths.Cervical cancer progr...BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia,accounting for 8.5%of all cancer-related deaths.Cervical cancer progression can be evaluated through laboratory tests to detect anaemia,an increased platelet count,and elevated inflammatory markers,therefore,effective laboratory examination is crucial for early detection and treatment of cervical cancer.AIM To evaluate the association between laboratory findings(haematology,haematology index,and inflammatory index)and the clinical stage of cervical cancer.METHODS This cross-sectional study analyzed adult cervical cancer patients’data from medical records and laboratory results including sociodemographic status,histopathological finding,clinical stage,and complete haematology examination.Numerical data was analyzed by the one-way ANOVA(normal data distribution),while the Kruskal-Wallis test was used for non-parametric data(abnormal distribution),followed by appropriate post-hoc analysis.The categorical data was analyzed by the Chi-square or Fisher Exact tests.The significance level was established at a P value<0.05.RESULTS This study involved the data of 208 adult cervical cancer patients and found no association between age,marital history,parity history,hormonal contraceptive use and cervical cancer stages.There were significant differences in the clinical laboratory test results based on the clinical stage of cervical cancer,including haemoglobin levels(P<0.001),leucocytes(P<0.001),neutrophils(P<0.001),monocytes(P=0.002),lymphocytes(P=0.006),platelets(P<0.001),neutrophil-lymphocyte ratio/NLR(P<0.001),lymphocyte-monocyte ratio/LMR(P<0.001),and plateletlymphocyte ratio/PLR(P<0.001).There were also significant differences in the systemic inflammatory index(SII)and systematic inflammatory response index(SIRI)between stage III+IV cervical cancer and stage II(SII P<0.001;SIRI P=0.001)and stage I(SII P<0.001;SIRI P=0.016),associated with the shifts in previously mentioned complete haematological values with cancer advancement.CONCLUSION The haematological parameters,inflammatory haematological ratios,and inflammatory indices exhibited significant differences between cervical cancer stages,therefore these tests can be utilized to evaluate cervical cancer progression.展开更多
BACKGROUND Cervical cancer,a prevalent gynecological malignancy,exhibits recurrence rates of 30%-50%post-treatment,with recurrent cases facing a dire 10%-20%long-term survival rate,severely impacting patients’mental ...BACKGROUND Cervical cancer,a prevalent gynecological malignancy,exhibits recurrence rates of 30%-50%post-treatment,with recurrent cases facing a dire 10%-20%long-term survival rate,severely impacting patients’mental health and quality of life.Fear of cancer recurrence(FCR)emerges as a critical psychological challenge,often leading to anxiety,social avoidance,and even suicidal tendencies.Despite its high prevalence,structured,evidence-based interventions for FCR in cervical cancer remain scarce,with most studies focusing on general psychological support rather than targeted strategies.The fear of progression theory provides a theoretical framework,highlighting cognitive-emotional conflicts arising from perceived threats of disease recurrence.Addressing this gap,this study developed a specialized,phased psychological intervention program grounded in fear of progression theory,aiming to reduce FCR and enhance resilience in cervical cancer survivors through multi-disciplinary strategies.AIM To establish a psychological intervention program to support the fear of cervical cancer recurrence and to alleviate the psychological pressure of patients after cervical cancer surgery.METHODS Thirteen experts were selected to conduct two rounds of correspondence through literature review and group discussions to amend the psychological intervention draft and form the basis for the psychological intervention.The selected experts also performed two rounds of correspondence to revise the psychological intervention draft and outline the first draft,and pre-experiments were conducted for further improvement of the psychological intervention program.Experiments were performed in 80 patients with cervical cancer to further improve the psychological intervention program of relapse fear support.RESULTS The expert authority coefficient of the first and second rounds was higher than 0.8,indicating high authority.The coordination coefficient>0.8 indicated high consistency with high significance(all P<0.05).The FCR Inventory,Kessler Psychological Distress Scale,Psychological Distress Thermometer,and General Hospital Anxiety and Depression Scale scores at 3 and 6 months in the study group were lower than those of the control group,and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Perceived Social Support Scale scores were higher than those of the control group(P<0.05).CONCLUSION The psychological intervention program of relapse fear support which considers the individual differences between patients and expert opinions,has a good scientific and practical basis,and can be used to enhance the quality of life of patients.展开更多
BACKGROUND Cervical cancer is a significant health concern among females in perimenopause,with a high prevalence of depression in this population.The rationale for this study was to explore the risk factors associated...BACKGROUND Cervical cancer is a significant health concern among females in perimenopause,with a high prevalence of depression in this population.The rationale for this study was to explore the risk factors associated with depression in patients in perimenopause with cervical cancer.We hypothesized that socioeconomic status,disease characteristics,and quality of life factors contributed to the development of depression in these patients.AIM To investigate the risk factors associated with depression in patients in perimenopause with cervical cancer.METHODS A retrospective study was conducted on 254 patients in perimenopause with cervical cancer admitted to a single center.Patients were divided into a nondepression group(n=152)and a depression group(n=102)based on whether depression occurred after treatment.Data collection included demographic,clinical,and psychosocial factors.The Hamilton Depression Rating Scale was used to assess depression.Logistic regression analysis was performed to identify risk factors.RESULTS Patients with depression more often had low income(<4000 China yuan:66.7%vs 6.6%,P<0.001),initial disease onset(70.6%vs 57.2%,P=0.001),low social support(70.6%vs 55.3%,P=0.014),pathological stages III-IV(70.6%vs 41.5%,P<0.001),high pain level(65.7%vs 34.2%,P<0.001),and poor sleep quality(67.6%vs 32.2%,P<0.001).Logistic regression identified low income[odds ratio(OR)=32.606,P<0.001],initial disease onset(OR=4.282,P=0.001),pathological stages III-IV(OR=4.123,P=0.0005),high pain level(OR=1.181,P=0.0000434),and poor sleep quality(OR=3.094,P=0.0041)as key risk factors.CONCLUSION Low income,initial onset,low support,advanced stages,high pain,and poor sleep quality increased depression risk in patients in perimenopause with cervical cancer.Studies investigating interventions for this population are needed.展开更多
BACKGROUND Anxiety and depression are highly prevalent among patients with cervical cancer(CC).However,few studies have systematically analyzed the psychological effects of tumor stage,treatment methods,and related fa...BACKGROUND Anxiety and depression are highly prevalent among patients with cervical cancer(CC).However,few studies have systematically analyzed the psychological effects of tumor stage,treatment methods,and related factors on these patients,or developed predictive models for these outcomes.AIM To identify factors influencing anxiety and depression in patients with CC and construct predictive models.METHODS We retrospectively analyzed data from 119 patients with CC treated at the Gynecology Department of Suzhou Ninth People’s Hospital between January 2017 and May 2025.Clinical data,psychological hope levels at diagnosis,and Self-Rating Anxiety Scale and Self-Rating Depression Scale scores during treatment were collected.Influencing factors were identified,and predictive models were developed.The model performance was evaluated using receiver operating characteristic(ROC)curves and the Hosmer-Lemeshow goodness-of-fit test.RESULTS During treatment,64.71%of the patients experienced anxiety and 52.10%experienced depression.Significant differences in family income,tumor stage,treatment modality,and hope level were observed between patients with and without anxiety/depression(P<0.05).Multivariate analysis showed that a family monthly income<5000 yuan,stage III-IV tumor,comprehensive treatment,and low hope level were independent risk factors(P<0.05).The predictive formula for anxiety was as follows:Logit(P)=0.795×monthly income+0.594×tumor stage+1.095×treatment method+1.184×hope level−9.176;for depression:Logit(P)=0.432×monthly income+0.518×tumor stage+0.727×treatment method+1.095×hope level−8.541.The area under the ROC curves were 0.865 for anxiety and 0.837 for depression.Goodness-of-fit test confirmed no overfitting(P>0.05).CONCLUSION Family income,tumor stage,treatment method,and hope level are key determinants of anxiety and depression in patients with CC.Predictive models incorporating these factors can effectively assess risk of anxiety and depression during treatment.展开更多
BACKGROUND Cervical spondylosis(CS)frequently co-occurs with generalized anxiety disorder(GAD),presenting a complex clinical challenge.Managing CS-related pain in patients with GAD is particularly challenging because ...BACKGROUND Cervical spondylosis(CS)frequently co-occurs with generalized anxiety disorder(GAD),presenting a complex clinical challenge.Managing CS-related pain in patients with GAD is particularly challenging because of the bidirectional relationship between pain and anxiety,necessitating integrated treatment strategies.AIM To evaluate the efficacy of electroacupuncture(EA)in treating CS-related pain and anxiety in patients with GAD.METHODS This retrospective cohort study analyzed data from 83 patients with CS-related pain and GAD who received EA treatment over 2-year period.Pain intensity was assessed using the visual analog scale,and anxiety symptoms were measured using the Hamilton Anxiety Rating Scale.Additionally,neuroinflammatory markers,including interleukin-6,tumor necrosis factor-alpha,and high-sensitivity C-reactive protein,were examined.Outcomes were evaluated at baseline,after 4 weeks,and after 8 weeks of treatment.RESULTS EA treatment significantly reduced CS-related pain(mean visual analog scale reduction:3.24±1.18;P<0.001)and improved anxiety symptoms(mean Hamilton Anxiety Rating Scale reduction:7.83±2.65;P<0.001)after 8 weeks of treatment.Neuroinflammatory markers also showed significant reductions,with interleukin-6 and tumor necrosis factor-alpha levels decreasing by 32.7%and 28.5%,respectively(P<0.01).Pain reduction was significantly correlated with improvements in anxiety symptoms(r=0.68;P<0.001)and a decrease in inflammatory markers(r=0.54;P<0.01).CONCLUSION EA demonstrates significant efficacy in reducing CS-related pain in patients with comorbid GAD,along with concurrent improvements in anxiety symptoms and neuroinflammatory profiles.These findings suggest that EA may offer a valuable integrative approach for managing this complex clinical presentation,potentially addressing both pain and anxiety through the modulation of neuroinflammatory pathways.展开更多
Objective:To evaluate the impact of government-organized screening on the economic burden among patients with cervical cancer and precancerous lesions,and explore mediating pathways across diagnosis,initial treatment,...Objective:To evaluate the impact of government-organized screening on the economic burden among patients with cervical cancer and precancerous lesions,and explore mediating pathways across diagnosis,initial treatment,radiotherapy/chemotherapy,follow-up,and recurrence/progression/metastasis.Methods:A multicentre,nationwide survey across 5 disease courses was conducted from 26 hospitals in China.Multivariable regression and structural equation modeling were used to assess the effects of government-organized screening on economic burden by comparing government-organized screening with workplace check-up,self-paid check-up,and symptom-based detection.Results:Workplace check-up,self-paid check-up,and symptom-based detection were associated with progressively higher costs across diagnosis[β:1.10,95%confidence interval(CI):0.54±1.67;β:1.46,95%CI:1.00±1.92;andβ:1.68,95%CI:1.25±2.11,respectively],initial treatment(β:0.36,95%CI:0.18±0.55;β:0.51,95%CI:0.35±0.66;andβ:0.56,95%CI:0.42±0.70,respectively),and follow-up(β:0.63,95%CI:0.38±0.88;β:0.83,95%CI:0.61±1.04;andβ:0.85,95%CI:0.65±1.06,respectively)compared to government-organized screening(all P<0.05).Earlier clinical staging and greater use of lower-level hospitals mediated 44.74%±54.97%of cost differences in diagnosis,73.27%±85.04%in initial treatment,and 30.38%±54.73%in follow-up.Fifteen percent of the cost differences during initial treatment were related to lower overtreatment for precancerous lesions.Conclusions:Government-led cervical cancer screening was associated with lower economic burden with pathways involving earlier-stage diagnosis,reduced overtreatment,and decreased reliance on higher-level hospitals,suggesting potential clinical benefits,efficient resource use,and improved equity in cancer care.展开更多
Cervical cancer is a major health threat to women worldwide.Since most cases are diagnosed at advanced stages,treatment outcomes are significantly less effective compared to those detected through early screening and ...Cervical cancer is a major health threat to women worldwide.Since most cases are diagnosed at advanced stages,treatment outcomes are significantly less effective compared to those detected through early screening and intervention.Therefore,the development of efficient noninvasive early screening techniques is crucial.This study proposes a cervical lesion classification method based on near-infrared spectroscopy(NIR).First,the feasibility of using NIR for screening cervical precancerous lesions was verified by simulating the optical properties of normal and cancerous cervical tissues.In addition,a noninvasive,portable NIR real-time acquisition system for cervical tissue was independently developed.Moreover,NIR spectral data from cervical tissues were collected from 248 participants,and the samples were categorized into four groups according to biopsy results,namely,healthy,CIN1,CIN2,and CIN3.A Transformer-based classification network was used to train and classify data.In the classification of diseased samples,the prediction accuracy for CIN1 was the highest(99.32%),followed by CIN2(93.33%)and CIN3(94.48%).The classification model shows significant potential for screening cervical cancer and precancerous lesions,offering strong technical support for the large-scale implementation of cervical cancer screening programs.展开更多
Objective:Cervical cancer remains a global health challenge with substantial disparities between countries.High-quality colposcopy is essential for cervical cancer prevention,yet training opportunities remain inadequa...Objective:Cervical cancer remains a global health challenge with substantial disparities between countries.High-quality colposcopy is essential for cervical cancer prevention,yet training opportunities remain inadequate worldwide.We developed the Intelligent Digital Education Tool for Colposcopy(iDECO)to address training gaps and evaluated the effect across diverse international settings.Methods:Six pre-post interventional training programmes were conducted in China,Mexico,and Mongolia from December 2024 to May 2025.A total of 369 trainees from 87 centers participated in a 3-week online training programme using iDECO,a bilingual webbased platform featuring authentic colposcopy cases,gamified learning pathways,and personalized analytics.The primary outcomes included colposcopy competence in general assessment,colposcopic findings,diagnostic accuracy,and management decisions.The secondary outcomes focused on participant feedback and satisfaction.Results:Of 369 participants who completed pretests,333(90.24%)completed post-training assessments.Significant improvements were observed across all competency domains.Diagnostic accuracy increased with an odds ratio(OR)of 1.72(95%CI:1.60±1.86)with the greatest gains in high-grade lesion identification[OR=2.27(95%CI:1.94±2.64)].Squamocolumnar junction visibility and transformation zone type assessments improved with ORs of 1.41(95%CI:1.31±1.51)and 1.87(95%CI:1.73±2.01),respectively.Biopsy decision-making accuracy also showed significant improvement[OR=2.09(95%CI:1.91±2.29)].International participants showed lower baseline performance but achieved the greatest improvements.Greater than 85%of participants rated the training highly satisfactory and 83.56%preferred intelligent training over traditional methods.Conclusions:iDECO-based training significantly improved colposcopy competence across diverse international settings with high user satisfaction.These findings support the potential for worldwide implementation of intelligent digital training tools to address colposcopy training gaps and contribute to the elimination of cervical cancer.展开更多
文摘Cervical cancer related to human papillomavirus(HPV)is a leading cause of cancer-related mortality among women worldwide.Cancer cells release fragments of their DNA,known as circulating tumor DNA(ctDNA),which can be detected in bodily fluids.A PubMed search using the terms“ctHPV”or“circulating tumor DNA”and“cervical cancer”,limited to the past ten years,identified 104 articles,complemented by hand-searching for literature addressing medico-legal implications.Studies were evaluated for relevance and methodological quality.Detection and characterization of circulating tumor HPV DNA(ctHPV DNA)have emerged as promising tools for assessing prognosis and disease recurrence in cervical cancer.Detection techniques include polymerase chain reaction(PCR),digital droplet PCR(ddPCR),and next-generation sequencing(NGS).This review summarizes current knowledge on ctHPV DNA in cervical cancer and explores its clinical and medico-legal implications,including management of discordant results,diagnostic errors,liability,and data protection compliance.
基金supported by the National Key R&D Program of China(grant number:2021YFC2500400)National Natural Science Foundation of China(grant numbers:82172894,82073028,82204121)China Postdoctoral Science Foundation(grant number:2023M742617).
文摘Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.
文摘This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in quality of life can significantly impact patients’lives.Currently,most treatments are supportive,with no specific treatment options available in Western medicine.Non-Western medicine,often less toxic and easier to administer,has shown promising results when used alongside radiotherapy for cervical cancer.Despite these potential benefits,challenges such as limited evidence and restricted application areas persist.While non-Western medicines may offer potential improvements in chemoradiotherapy outcomes for cervical cancer,further research is necessary to substantiate these benefits.
文摘BACKGROUND Cervical cancer is a formidable global health issue,particularly affecting women in lower-middle-income countries with little or no access to preventative vaccines,screening programs,and treatment modalities.The case report presents a unique case of a large cervical cancer achieving complete response(CR)with concurrent chemoradiotherapy(CCRT),highlighting the effectiveness of this treatment approach even in advanced stages and underscoring the importance of adaptive radiotherapy(RT)in optimizing patient outcomes.CASE SUMMARY We present the case of a 53-year-old woman who presented with four years of abnormal vaginal bleeding and was found to have p16-positive,moderately differentiated cervical squamous cell carcinoma.The tumor measured 14 cm×12 cm×8 cm,the largest size reported in the literature to achieve CR with CCRT.Despite this monumental feat,the patient remained disease-free and is currently on follow-up for 2 years;however,she continued to suffer from substantial morbidity caused by a vesicovaginal fistula and hydronephrosis,underscoring the continuing impact of cervical cancer on quality of life.CONCLUSION In this case report,we highlight the effectiveness of CCRT in achieving CR,even in cases of bulky cervical cancer,with adaptive RT offering a customized strategy to improve patient outcomes.We also emphasize the necessity for multidisciplinary team discussions and highlight the need for strategies to mitigate treatment-related toxicities and long-term complications.
基金supported by Hunan Provincial Key Research and Development Program,No.2021SK2002(to BW)the Natural Science Foundation of Hunan Province of China(General Program),No.2021JJ30938(to YL)。
文摘Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological biomarkers for acute spinal cord injury,few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy.This study involved 30 patients with degenerative cervical myelopathy(51.3±7.3 years old,12 women and 18 men),seven healthy controls(25.7±1.7 years old,one woman and six men),and nine patients with cervical spondylotic radiculopathy(51.9±8.6 years old,three women and six men).Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics.Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities.Using least absolute shrinkage and selection operator analysis,we constructed a five-gene model(TBCD,TPM2,PNKD,EIF4G2,and AP5Z1)to diagnose degenerative cervical myelopathy with an accuracy of 93.5%.One-gene models(TCAP and SDHA)identified mild and severe degenerative cervical myelopathy with accuracies of 83.3%and 76.7%,respectively.Signatures of two immune cell types(memory B cells and memory-activated CD4^(+)T cells)predicted levels of lesions in degenerative cervical myelopathy with 80%accuracy.Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.
文摘Cervical cancer is the fourth most common cancer worldwide, accounting for 6.8% of new cancer cases and 8.1% of cancer-related deaths. About 85% of these deaths occurred in low- and middle-income countries. The aim of this study was to assess the frequency and distribution of the human papillomavirus (HPV) genotypes in women showing cytological abnormalities of the cervix at the Sourô SANOU University Hospital (CHUSS) in Bobo-Dioulasso, Burkina Faso. This is a descriptive study of women recruited at the CHUSS. The cervico-uterine smear examination was carried out at the CHUSS Anatomy and Pathology Department for cervical cancer screening. The data were collected from women with atypical cells on their cervico-uterine smear. Cervicovaginal samples were taken from consenting women and HPV genotyping was performed using the HPV Direct FLOW CHIP kit at CERBA. We obtained approval from the ethics committee. The data were analyzed using the SPSS 26 software. The results of the study showed that 67.79% of the participants were aged between 50 and 65, a group that is particularly vulnerable to persistent infection with high-risk oncogenic HPV genotypes. Of the women screened, 40.7% were HPV positive and 29.2% had multiple infections. The most common genotypes were HPV 35, followed by HPV 18, 52, 58 and 66. These data highlight the need for increased surveillance and targeted prevention strategies among this female population.
文摘Background: Early research describing the concept of intensity-modulated conformal radiotherapy (IMRT) was based on 7 to 9 beams to reach an adequate level of modulation. Nevertheless, its implementation demands significant resources. Our objective was to compare the compliance and homogeneity of target dose distribution between simplified IMRT and 3D-CRT in patients with cervical cancer and to assess the clinical value of simplified IMRT. Materials and Methods: From 2016 to 2017, 17 patients with stage IIB - IIIC cervical cancer were treated with external beam radiotherapy using simplified IMRT (12 cases) or 3DCRT (05 cases) and brachytherapy. Prior to radiotherapy, CT scans were conducted to delineate the target volume. The clinical target volume (CTV) included the uterus, primary tumor, supravaginal portion of the cervix, paracervical tissue, common iliac, internal and external iliac lymph nodes, obturator, and pre sacral lymph nodes, and the surrounding tissues. If the lower vagina was involved, the target volume included the whole vagina. The planning target volume (PTV) included the CTV with 1 cm anteriorly and 0.5 cm in all other directions. The PTV received 95% of 45 Gy (1.8 Gy/25 fraction). Dose-volume histogram, conformity index, homogeneity index, and treatment time per fraction were compared. Results: The 3D-CRT plan was more homogeneous than the simplified IMRT plan, while the simplified IMRT plan was more conformal. The volume of small bowels that received high-dose radiation significantly increased with simplified IMRT compared to 3D-CRT. Treatment time per fraction was 6 and 13 minutes for 3D-CRT and simplified IMRT, respectively. Conclusion: The simplified IMRT treatment plan is technically and dosimetrically acceptable and an alternative to the classic 3D-CRT plan for cervical cancer. It provides better dose distribution than 3D-CRT. However, the 3D-CRT treatment plan significantly reduced the overall treatment time per fraction.
基金supported by a project funded by the Hebei Provincial Central Guidance Local Science and Technology Development Fund(236Z7714G)。
文摘Cervical cancer,a leading malignancy globally,poses a significant threat to women's health,with an estimated 604,000 new cases and 342,000 deaths reported in 2020^([1]).As cervical cancer is closely linked to human papilloma virus(HPV)infection,early detection relies on HPV screening;however,late-stage prognosis remains poor,underscoring the need for novel diagnostic and therapeutic targets^([2]).
基金supported by the CAMS Innovation Fund for Medical Sciences(No.2023-I2M-3-019)National Natural Science Foundation of China(No.82404366)。
文摘In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strategies:human papillomavirus(HPV)vaccination,cervical cancer screening,and treatment of precancerous lesions and cancer.Subsequently,the WHO and its partners developed a global strategy to accelerate the reduction of cervical cancer incidence,with an ultimate goal of achieving elimination within the next century.This Global Strategy represents a formal international commitment and is anchored in the 90-70-90 targets to be achieved by 2030.In parallel,several countries have also set national commitments,such as Sweden's pledge to achieve elimination by 2027 and Australia's target of achieving elimination by 2035.
基金Supported by the Wuxi Municipal Health Commission Maternal and Child Health Research Project,No.FYKY202202.
文摘BACKGROUND The full implementation of the national two-child policy has presented significant challenges in ensuring the safety of pregnant women.AIM To investigate the effect of cervical balloon fluid volume on maternal processes,maternal and infant outcomes,and anxiety during pregnancy.METHODS A total of 100 singleton term pregnancies with cervical maturity induction and anxiety were selected using a lottery method;50 women were included.Cervical balloons were used for all participants.In the control group,80 mL of fluid was injected into both balloons;in the observation group,80 and 100 mL were injected into the vaginal and cervical balloons,respectively.The two groups were compared for cervical maturity,labor duration,anxiety,maternal and infant outcomes,and effects on cervical ripening.RESULTS After treatment,the cervical maturity test(Bishop)score was significantly higher in the observation group(9.76±1.19)than in the control group(7.62±0.83),and the Hamilton Anxiety Scale score was lower in the observation group(7.32±0.85)than in the control group(13.05±1.12).The observation group showed higher rates of natural delivery and lower rates of cesarean section than the control group.The first and total stages of labor were shorter in the observation than in the control group;no significant differences were found in the second and third stages.The incidence of complications was lower in the observation group[1(2.00%)vs 9(18.00%)for complications;49(98.00%)vs 41(82.00%)for non-complications].CONCLUSION The selected fluid volumes to promote cervical maturity and induce labor stabilize maternal mood,increase the natural delivery rate,shorten labor,and improve maternal and infant outcomes.
文摘As the 30th anniversary of the landmark Beijing Fourth World Conference on Women approaches,the forthcoming 2025 World Women's Summit in Beijing offers a timely platform to reaffirm commitments to women's well-being worldwide.In alignment with this milestone,Cancer Biology&Medicine is proud to present this special issue dedicated to accelerating the global elimination of cervical cancer.
文摘Objective:To investigate the effects of arecoline on HPV-positive cervical cells and unveil its underlying mechanism in cervical carcinogenesis.Methods:The cytotoxicity of arecoline was determined and the effect of subtoxic concentrations of arecoline on the expression of viral oncoproteins and transcriptional factors was examined in CaSki and SiHa cells.HPV16 promoter activity was evaluated in a plasmid containing HPV16 long control region(pGL3-HPV16LCR)-transfected cells.Cell proliferation,cell migration,and number of colonies were assessed by MTT,wound healing assay,and colony-forming assay,respectively.Results:Arecoline at 0.01μg/mL significantly upregulated HPV16 E6 and E7 oncoproteins in both CaSki and SiHa cells.It also upregulated the expression level of c-Fos and c-Jun mRNAs,and c-Myc protein in CaSki and SiHa cells.In addition,arecoline at subtoxic concentrations(0.0025 and 0.01μg/mL)significantly induced HPV16 promoter activity in pGL3-16LCR-transfected cells.It also promoted SiHa and CaSki cell proliferation,migration,and colony formation.Conclusions:Arecoline at subtoxic concentrations promotes the proliferation,migration,and colony formation of CaSki and SiHa cells via upregulation of c-Fos,c-Jun,c-Myc,and HPV16 E6 and E7 expressions.
文摘BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia,accounting for 8.5%of all cancer-related deaths.Cervical cancer progression can be evaluated through laboratory tests to detect anaemia,an increased platelet count,and elevated inflammatory markers,therefore,effective laboratory examination is crucial for early detection and treatment of cervical cancer.AIM To evaluate the association between laboratory findings(haematology,haematology index,and inflammatory index)and the clinical stage of cervical cancer.METHODS This cross-sectional study analyzed adult cervical cancer patients’data from medical records and laboratory results including sociodemographic status,histopathological finding,clinical stage,and complete haematology examination.Numerical data was analyzed by the one-way ANOVA(normal data distribution),while the Kruskal-Wallis test was used for non-parametric data(abnormal distribution),followed by appropriate post-hoc analysis.The categorical data was analyzed by the Chi-square or Fisher Exact tests.The significance level was established at a P value<0.05.RESULTS This study involved the data of 208 adult cervical cancer patients and found no association between age,marital history,parity history,hormonal contraceptive use and cervical cancer stages.There were significant differences in the clinical laboratory test results based on the clinical stage of cervical cancer,including haemoglobin levels(P<0.001),leucocytes(P<0.001),neutrophils(P<0.001),monocytes(P=0.002),lymphocytes(P=0.006),platelets(P<0.001),neutrophil-lymphocyte ratio/NLR(P<0.001),lymphocyte-monocyte ratio/LMR(P<0.001),and plateletlymphocyte ratio/PLR(P<0.001).There were also significant differences in the systemic inflammatory index(SII)and systematic inflammatory response index(SIRI)between stage III+IV cervical cancer and stage II(SII P<0.001;SIRI P=0.001)and stage I(SII P<0.001;SIRI P=0.016),associated with the shifts in previously mentioned complete haematological values with cancer advancement.CONCLUSION The haematological parameters,inflammatory haematological ratios,and inflammatory indices exhibited significant differences between cervical cancer stages,therefore these tests can be utilized to evaluate cervical cancer progression.
文摘BACKGROUND Cervical cancer,a prevalent gynecological malignancy,exhibits recurrence rates of 30%-50%post-treatment,with recurrent cases facing a dire 10%-20%long-term survival rate,severely impacting patients’mental health and quality of life.Fear of cancer recurrence(FCR)emerges as a critical psychological challenge,often leading to anxiety,social avoidance,and even suicidal tendencies.Despite its high prevalence,structured,evidence-based interventions for FCR in cervical cancer remain scarce,with most studies focusing on general psychological support rather than targeted strategies.The fear of progression theory provides a theoretical framework,highlighting cognitive-emotional conflicts arising from perceived threats of disease recurrence.Addressing this gap,this study developed a specialized,phased psychological intervention program grounded in fear of progression theory,aiming to reduce FCR and enhance resilience in cervical cancer survivors through multi-disciplinary strategies.AIM To establish a psychological intervention program to support the fear of cervical cancer recurrence and to alleviate the psychological pressure of patients after cervical cancer surgery.METHODS Thirteen experts were selected to conduct two rounds of correspondence through literature review and group discussions to amend the psychological intervention draft and form the basis for the psychological intervention.The selected experts also performed two rounds of correspondence to revise the psychological intervention draft and outline the first draft,and pre-experiments were conducted for further improvement of the psychological intervention program.Experiments were performed in 80 patients with cervical cancer to further improve the psychological intervention program of relapse fear support.RESULTS The expert authority coefficient of the first and second rounds was higher than 0.8,indicating high authority.The coordination coefficient>0.8 indicated high consistency with high significance(all P<0.05).The FCR Inventory,Kessler Psychological Distress Scale,Psychological Distress Thermometer,and General Hospital Anxiety and Depression Scale scores at 3 and 6 months in the study group were lower than those of the control group,and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Perceived Social Support Scale scores were higher than those of the control group(P<0.05).CONCLUSION The psychological intervention program of relapse fear support which considers the individual differences between patients and expert opinions,has a good scientific and practical basis,and can be used to enhance the quality of life of patients.
基金Natural Science Key Research Project of Bengbu Medical University,No.2021byzd098.
文摘BACKGROUND Cervical cancer is a significant health concern among females in perimenopause,with a high prevalence of depression in this population.The rationale for this study was to explore the risk factors associated with depression in patients in perimenopause with cervical cancer.We hypothesized that socioeconomic status,disease characteristics,and quality of life factors contributed to the development of depression in these patients.AIM To investigate the risk factors associated with depression in patients in perimenopause with cervical cancer.METHODS A retrospective study was conducted on 254 patients in perimenopause with cervical cancer admitted to a single center.Patients were divided into a nondepression group(n=152)and a depression group(n=102)based on whether depression occurred after treatment.Data collection included demographic,clinical,and psychosocial factors.The Hamilton Depression Rating Scale was used to assess depression.Logistic regression analysis was performed to identify risk factors.RESULTS Patients with depression more often had low income(<4000 China yuan:66.7%vs 6.6%,P<0.001),initial disease onset(70.6%vs 57.2%,P=0.001),low social support(70.6%vs 55.3%,P=0.014),pathological stages III-IV(70.6%vs 41.5%,P<0.001),high pain level(65.7%vs 34.2%,P<0.001),and poor sleep quality(67.6%vs 32.2%,P<0.001).Logistic regression identified low income[odds ratio(OR)=32.606,P<0.001],initial disease onset(OR=4.282,P=0.001),pathological stages III-IV(OR=4.123,P=0.0005),high pain level(OR=1.181,P=0.0000434),and poor sleep quality(OR=3.094,P=0.0041)as key risk factors.CONCLUSION Low income,initial onset,low support,advanced stages,high pain,and poor sleep quality increased depression risk in patients in perimenopause with cervical cancer.Studies investigating interventions for this population are needed.
基金Supported by 2024 Hospital-Level Research Start-up Fund,No.YK202426Suzhou Wujiang District"Science and Education for Health"Project,No.WWK202201Development Fund Project of the Affiliated Hospital of Xuzhou Medical University,No.XYFY202423.
文摘BACKGROUND Anxiety and depression are highly prevalent among patients with cervical cancer(CC).However,few studies have systematically analyzed the psychological effects of tumor stage,treatment methods,and related factors on these patients,or developed predictive models for these outcomes.AIM To identify factors influencing anxiety and depression in patients with CC and construct predictive models.METHODS We retrospectively analyzed data from 119 patients with CC treated at the Gynecology Department of Suzhou Ninth People’s Hospital between January 2017 and May 2025.Clinical data,psychological hope levels at diagnosis,and Self-Rating Anxiety Scale and Self-Rating Depression Scale scores during treatment were collected.Influencing factors were identified,and predictive models were developed.The model performance was evaluated using receiver operating characteristic(ROC)curves and the Hosmer-Lemeshow goodness-of-fit test.RESULTS During treatment,64.71%of the patients experienced anxiety and 52.10%experienced depression.Significant differences in family income,tumor stage,treatment modality,and hope level were observed between patients with and without anxiety/depression(P<0.05).Multivariate analysis showed that a family monthly income<5000 yuan,stage III-IV tumor,comprehensive treatment,and low hope level were independent risk factors(P<0.05).The predictive formula for anxiety was as follows:Logit(P)=0.795×monthly income+0.594×tumor stage+1.095×treatment method+1.184×hope level−9.176;for depression:Logit(P)=0.432×monthly income+0.518×tumor stage+0.727×treatment method+1.095×hope level−8.541.The area under the ROC curves were 0.865 for anxiety and 0.837 for depression.Goodness-of-fit test confirmed no overfitting(P>0.05).CONCLUSION Family income,tumor stage,treatment method,and hope level are key determinants of anxiety and depression in patients with CC.Predictive models incorporating these factors can effectively assess risk of anxiety and depression during treatment.
文摘BACKGROUND Cervical spondylosis(CS)frequently co-occurs with generalized anxiety disorder(GAD),presenting a complex clinical challenge.Managing CS-related pain in patients with GAD is particularly challenging because of the bidirectional relationship between pain and anxiety,necessitating integrated treatment strategies.AIM To evaluate the efficacy of electroacupuncture(EA)in treating CS-related pain and anxiety in patients with GAD.METHODS This retrospective cohort study analyzed data from 83 patients with CS-related pain and GAD who received EA treatment over 2-year period.Pain intensity was assessed using the visual analog scale,and anxiety symptoms were measured using the Hamilton Anxiety Rating Scale.Additionally,neuroinflammatory markers,including interleukin-6,tumor necrosis factor-alpha,and high-sensitivity C-reactive protein,were examined.Outcomes were evaluated at baseline,after 4 weeks,and after 8 weeks of treatment.RESULTS EA treatment significantly reduced CS-related pain(mean visual analog scale reduction:3.24±1.18;P<0.001)and improved anxiety symptoms(mean Hamilton Anxiety Rating Scale reduction:7.83±2.65;P<0.001)after 8 weeks of treatment.Neuroinflammatory markers also showed significant reductions,with interleukin-6 and tumor necrosis factor-alpha levels decreasing by 32.7%and 28.5%,respectively(P<0.01).Pain reduction was significantly correlated with improvements in anxiety symptoms(r=0.68;P<0.001)and a decrease in inflammatory markers(r=0.54;P<0.01).CONCLUSION EA demonstrates significant efficacy in reducing CS-related pain in patients with comorbid GAD,along with concurrent improvements in anxiety symptoms and neuroinflammatory profiles.These findings suggest that EA may offer a valuable integrative approach for managing this complex clinical presentation,potentially addressing both pain and anxiety through the modulation of neuroinflammatory pathways.
基金supported by the Bill&Melinda Gates Foundation(Grant no.OPP1216421)CAMS Innovation Fund for Medical Sciences[CIFMS](Grant no.2021-I2M-1-004)。
文摘Objective:To evaluate the impact of government-organized screening on the economic burden among patients with cervical cancer and precancerous lesions,and explore mediating pathways across diagnosis,initial treatment,radiotherapy/chemotherapy,follow-up,and recurrence/progression/metastasis.Methods:A multicentre,nationwide survey across 5 disease courses was conducted from 26 hospitals in China.Multivariable regression and structural equation modeling were used to assess the effects of government-organized screening on economic burden by comparing government-organized screening with workplace check-up,self-paid check-up,and symptom-based detection.Results:Workplace check-up,self-paid check-up,and symptom-based detection were associated with progressively higher costs across diagnosis[β:1.10,95%confidence interval(CI):0.54±1.67;β:1.46,95%CI:1.00±1.92;andβ:1.68,95%CI:1.25±2.11,respectively],initial treatment(β:0.36,95%CI:0.18±0.55;β:0.51,95%CI:0.35±0.66;andβ:0.56,95%CI:0.42±0.70,respectively),and follow-up(β:0.63,95%CI:0.38±0.88;β:0.83,95%CI:0.61±1.04;andβ:0.85,95%CI:0.65±1.06,respectively)compared to government-organized screening(all P<0.05).Earlier clinical staging and greater use of lower-level hospitals mediated 44.74%±54.97%of cost differences in diagnosis,73.27%±85.04%in initial treatment,and 30.38%±54.73%in follow-up.Fifteen percent of the cost differences during initial treatment were related to lower overtreatment for precancerous lesions.Conclusions:Government-led cervical cancer screening was associated with lower economic burden with pathways involving earlier-stage diagnosis,reduced overtreatment,and decreased reliance on higher-level hospitals,suggesting potential clinical benefits,efficient resource use,and improved equity in cancer care.
基金supported by the China Pharmaceutical University and funded by National Natural Science Foundation of China(Nos.81827803 and 82151311)Fundamental Research Funds for the Central Universities(Nos.NP2024102,NJ2024016,and NJ2024029)+1 种基金Jiangsu Funding Program for Excellent Postdoctoral Talent(No.2024ZB661)Key Project of Nanjing Health Science and Technology Development Special Fund(No.ZKX24043).
文摘Cervical cancer is a major health threat to women worldwide.Since most cases are diagnosed at advanced stages,treatment outcomes are significantly less effective compared to those detected through early screening and intervention.Therefore,the development of efficient noninvasive early screening techniques is crucial.This study proposes a cervical lesion classification method based on near-infrared spectroscopy(NIR).First,the feasibility of using NIR for screening cervical precancerous lesions was verified by simulating the optical properties of normal and cancerous cervical tissues.In addition,a noninvasive,portable NIR real-time acquisition system for cervical tissue was independently developed.Moreover,NIR spectral data from cervical tissues were collected from 248 participants,and the samples were categorized into four groups according to biopsy results,namely,healthy,CIN1,CIN2,and CIN3.A Transformer-based classification network was used to train and classify data.In the classification of diseased samples,the prediction accuracy for CIN1 was the highest(99.32%),followed by CIN2(93.33%)and CIN3(94.48%).The classification model shows significant potential for screening cervical cancer and precancerous lesions,offering strong technical support for the large-scale implementation of cervical cancer screening programs.
基金supported by CAMS Innovation Fund for Medical Sciences(CIFMS 2021-I2M-1-004)Tencent Sustainable Social Value Inclusive Health Lab and through the ChongQing Tencent Sustainable Development Foundation"Comprehensive Prevention and Control Demonstration Project for Eliminating Cervical Cancer and Breast Cancer in Low Health Resource Areas of China"(Project No.SD20240904145730)+1 种基金Tencent Sustainable Social Value Inclusive Health Lab(Project No.SSVPJ202307060001)Sanming Project of Medicine in Shenzhen(Project No.SZSM202211032)。
文摘Objective:Cervical cancer remains a global health challenge with substantial disparities between countries.High-quality colposcopy is essential for cervical cancer prevention,yet training opportunities remain inadequate worldwide.We developed the Intelligent Digital Education Tool for Colposcopy(iDECO)to address training gaps and evaluated the effect across diverse international settings.Methods:Six pre-post interventional training programmes were conducted in China,Mexico,and Mongolia from December 2024 to May 2025.A total of 369 trainees from 87 centers participated in a 3-week online training programme using iDECO,a bilingual webbased platform featuring authentic colposcopy cases,gamified learning pathways,and personalized analytics.The primary outcomes included colposcopy competence in general assessment,colposcopic findings,diagnostic accuracy,and management decisions.The secondary outcomes focused on participant feedback and satisfaction.Results:Of 369 participants who completed pretests,333(90.24%)completed post-training assessments.Significant improvements were observed across all competency domains.Diagnostic accuracy increased with an odds ratio(OR)of 1.72(95%CI:1.60±1.86)with the greatest gains in high-grade lesion identification[OR=2.27(95%CI:1.94±2.64)].Squamocolumnar junction visibility and transformation zone type assessments improved with ORs of 1.41(95%CI:1.31±1.51)and 1.87(95%CI:1.73±2.01),respectively.Biopsy decision-making accuracy also showed significant improvement[OR=2.09(95%CI:1.91±2.29)].International participants showed lower baseline performance but achieved the greatest improvements.Greater than 85%of participants rated the training highly satisfactory and 83.56%preferred intelligent training over traditional methods.Conclusions:iDECO-based training significantly improved colposcopy competence across diverse international settings with high user satisfaction.These findings support the potential for worldwide implementation of intelligent digital training tools to address colposcopy training gaps and contribute to the elimination of cervical cancer.
