Cervical cancer is a form of malignant tumor that seriously threatens women’s health. In China,according to the cancer statistics, 98,900 new cervical cancer cases and 30,500 deaths due to cervical cancer were estima...Cervical cancer is a form of malignant tumor that seriously threatens women’s health. In China,according to the cancer statistics, 98,900 new cervical cancer cases and 30,500 deaths due to cervical cancer were estimated to have occurred in2015, and the incidence and mortality rates still exhibited an upward trend[1].展开更多
Aims:Vanuatu is a lower-and middle-income country in the Pacific with a cervical cancer incidence of 100 per 100,000 women.An opportunistic screening program has existed since 2008,with continuous data collection rela...Aims:Vanuatu is a lower-and middle-income country in the Pacific with a cervical cancer incidence of 100 per 100,000 women.An opportunistic screening program has existed since 2008,with continuous data collection related to this since 2015.Methods:We analysed al cervical cancer screening data for Vanuatu over 6 years,and conducted a descriptive analysis of number of women screened,the results of screening,the treatment rates of human papil omavirus(HPV)positivity or cytological abnormalities detected through screening,and the incidence of cervical cancer.The chal enges encountered during the implementation of the screening program are also described.Results:Data were available from 01/01/2015 to 31/12/2020.Based on census data,70,081 women were eligible for screening,and 15,696(22.4%)women underwent screening at least once.Screening coverage included 13.2%of individuals under 30 years,33.2%of individuals in the 30-50 age group,and 15.8%of people over 50 years.A total of 8910 HPV tests were conducted,of which 876(9.8%)were positive.Among the HPV-positive cases,316 received large loop excision of the transformation zone(LLETZ)treatment,156(49.4%)of which were high grade and 2(0.6%)of which were cancer.A total of 13,396 Pap smear tests were conducted,with 315(2.4%)showing high-grade results and 226(1.7%)indicating possible high-grade results.Overal,119 cancers were diagnosed from 15,696 women screened(0.8%),including 6/3297(0.2%)of<30 years,75/10,089(0.7%)of 30-50 years,38/2310(1.6%)of>50 years.Conclusion:One in five eligible Ni-Vanuatu women have undergone cervical cancer screening since 2015,with 7.6 per 1000 women having malignant results and 40.4 per 1000 women having high-grade or possible high-grade results.展开更多
In response to the incidence of cervical intraepithelial neoplasia and cervical cancer in China and global screening strategies,a collaborative effort was undertaken by seven Chinese medical associations to develop th...In response to the incidence of cervical intraepithelial neoplasia and cervical cancer in China and global screening strategies,a collaborative effort was undertaken by seven Chinese medical associations to develop this guideline for cervical cancer screening.The guideline recommends high-risk human papillomavirus(hr-HPV)testing as the preferred method for primary screening,which should have been approved by authoritative institutions and clinically validated for primary screening.In areas without access to HPV testing,cytology can be used as an alternative.However,it is recommended to replace cytology with HPV-based screening as conditions permit.Cotesting(HPV testing in combination with cytology)is recommended for areas with sufficient medical resources,opportunistic screening populations,and partial special populations.The guideline recommends that individuals with a cervix initiate cervical cancer screening at the age 25 years and undergo HPV testing alone or cotesting every five years,or cytology alone every three years.Women over the age of 65 who have had documented adequate negative prior screening in the past may terminate screening.Corresponding screening programs are proposed for different special populations.The development of these guidelines is an important step in the effort to eliminate cervical cancer in China.展开更多
Background: The incidence of cervical cancer is high in Bangladesh and there is a high prevalence of preinvasive lower genital tract disease among women of reproductive age. Persistent high-risk Human Papilloma Virus ...Background: The incidence of cervical cancer is high in Bangladesh and there is a high prevalence of preinvasive lower genital tract disease among women of reproductive age. Persistent high-risk Human Papilloma Virus (HPV) infection is the main underlying cause of cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN). Objective: The aim of the study was to identify the subtypes of high-risk HPV infection among women with the colposcopic diagnosis of cervical intraepithelial neoplasia in Bangladesh. Methods: This cross-sectional observational study was conducted in the colposcopy clinic of Dhaka Medical College Hospital over a six-month period. A total of 100 participants were enrolled. Married women, between 30 - 60 years of age with colposcopically diagnosed cervical intra epithelial neoplasia were enrolled. Women with chronic illness, pregnancy, and women unable to consent were excluded from this study. After counselling, colposcopically directed punch biopsies were taken from each CIN case concurrently with high-risk HPV testing by polymerase chain reaction (PCR). Results: The mean age of the patients was 38.69 (SD ±7.76) years. CIN 1 was diagnosed in 57% of participants, while 24% had CIN II and 19% had CIN III lesions. High-risk HPV was present in 52 patients. HPV 16 was the most common identified in 28 (53.84%) and HPV 18 was the second most common with 20 (38.46%) either singly or in combination with other high-risk subtypes. The other HPV strains, HPV 31, 33, 35, 52, 56 and 58, were also detected either as mono or co-infections. Out of the 52 HPV positive cases, 29 (55.8%) had mono infection and 23 (44.2%) had co-infection with several subtypes. The highest incidence (50%) of oncogenic HPV infections was present among women aged 35 - 45 years. Risk factors associated with HPV positive cases were high parity (P 0.05), early age at marriage (P = 0.754) and early age of first child. Conclusion: This study identified a high prevalence of HPV 16 and 18 genotypes. HPV vaccination with the current 9-valent HPV vaccine, which contains HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. Will be an effective public health measure to eradicate cervical cancer in Bangladesh.展开更多
Objective: To acquire a ribozyme against the E6 gene of human papillomaviruses type 16 (HPV16E6) and investigate its effects on the phenotypes and gene expression of cervical cancer cell line. Methods: Anti-HPV16E6 ri...Objective: To acquire a ribozyme against the E6 gene of human papillomaviruses type 16 (HPV16E6) and investigate its effects on the phenotypes and gene expression of cervical cancer cell line. Methods: Anti-HPV16E6 ribozyme (HRz) was designed by computer programs and its activity identified by cleavage experiment in vitro before its transfection via lipofectin into CaSKi cells with the empty eucaryotic expression plasmid transfection of the cells also performed, the resultant cells designated as CaSKi-R, CaSKi-P respectively. The morphology and the soft agar forming ability were studied in CaSKi cells and the transfected cells, and the expression of E6, proliferating cell nuclear antigen (PCNA) and C-erbB-2 genes assayed by flow cytometry. The tumorgenicity of each cell line was evaluated in nude mice receiving inoculations of CaSKi, CaSKi-R and CaSKi-P cells separately, while in one group, both CaSKi and CaSKi-R cells were inoculated on different sides of the mice. Results: HRz was able to cleave HPV16E6 mRNA in a site-specific manner and could be expressed stably in transfected CaSKi cells. Northern blot analysis showed that E6 mRNA was less in CaSKi-R than in CaSKi cells, and no significant difference in the morphology and growth rate was observed between CaSKi and CaSKi-P cells, but the growth rate CaSKi-R was lowered. The colony-forming rate of CaSKi-P in soft agar was similar to that of CaSKi cells, while that of CaSKi-R was decreased. Flow cytometry showed that anti-HPV16E6 ribozyme reduced the expression of E6, PCNA and C-erbB-2 genes in CaSKi-R cells, but not in CaSKi-P cells. The tumorgenicity of CaSKi-R in nude mice was decreased compared with CaSKi cells. Conclusion: HRz can partially reverse the malignant phenotype of CaSKi cells, possibly due to decreased E6 gene expression, and the consequent decrease of PCNA and C-erbB-2 gene expressions.展开更多
High-risk human papillomavirus (hrHPV) infection plays an important role in the development of cervical intraepithelial neoplasia and cervical cancer.A total of 11 549 women were enrolled from the Maternal and Child H...High-risk human papillomavirus (hrHPV) infection plays an important role in the development of cervical intraepithelial neoplasia and cervical cancer.A total of 11 549 women were enrolled from the Maternal and Child Health Hospital of Hubei Province.Each participant accepted hrHPV testing and completed a self^administered questionnaire about basic information and potential risk factors.The univariable and multivariable logistic regression model was used to explore the associations between variants and hrHPV infection.Our results showed that hrHPV prevalence was 16.09% in Hubei Province,among which,hrHPV was more likely to be positive in women aged 51 years or above (OR=1.65,95% CI:1.28-2.14),and in women who had symptoms of bleeding after intercourse (OR=1.32,95% CI:1.17-1.50),had first sexual intercourse at the age of 18 years or below (OR=1.33,95% CI:1.07-1.64),had at least three male sexual partners (OR=2.50,95% CI:2.07-3.03),and who had been diagnosed with sexually transmitted infections (OR=1.50,95% CI:1.12-2.03).Married women (OR=0.66,95% CI:0.55-0.78) and women who frequently used condoms (OR=0.75,95% CI:0.67-0.84) had a relatively lower hrHPV prevalence.This study confirms that hrHPV infection was associated with age,marital status,symptoms of intercourse bleeding,history of sexually transmitted infections,and sex-related behaviors.Above all,this study provides a baseline database prior to obtaining vaccinations for dynamic tracking of the changes in hrHPV prevalence.展开更多
Objective: To explore the predictors of intermediate endpoints of cervical cancer in 500 women living in Porto Alegre. Study design: Five hundred randomly selected women (mean age 20.3 years, range 15-25) were screene...Objective: To explore the predictors of intermediate endpoints of cervical cancer in 500 women living in Porto Alegre. Study design: Five hundred randomly selected women (mean age 20.3 years, range 15-25) were screened using PCR detecting 25 HPV types (HPV6, 11, 16, 18, 31, 33, 34, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 66, 68, 70, and 74)-. Women were interviewed and serum samples were analysed for antibodies to HPV16 and HPV18 VLPs. Regression models were constructed to analyse predictive factors for (a) HPV PCR status, (b)HPV16-seropositivity,(c)HPV18-seropositivity, and (d) SIL in the PAP smear, used as intermediate endpoints of cervical cancer. Results: Specific HPV types were identified in 137 (27.4%) of the 157 (31.4%) PCR-positive women. PAP test result was the most powerful independent predictor of HPV status in PCR (p = 0.0001), followed by the sexual activity started (p = 0.001) (adjusted OR 34.075, 95%CI: 4.650-249.715). PAP test SIL was independently predicted only by the HPV PCR status (p = 0.0001) (OR 7.561, 95%CI: 2.787-20.514). HPV16 and HPV18 serostatus were the most significant predictors of each other (p = 0.0001), and the life-time number of sexual partners was more significant (p = 0.001) predictor of HPV16 than HPV18 serostatus (p = 0.049). Conclusion: These data are useful in evaluating the exposure status of the women to the risk factors of cervical cancer in south of Brazil.展开更多
Objective The purpose of this study is to provide reference and guidance for the clinical diagnosis and treatment of vulvar malignancies.Method This article sorts out and integrates the contents of vulvar malignancies...Objective The purpose of this study is to provide reference and guidance for the clinical diagnosis and treatment of vulvar malignancies.Method This article sorts out and integrates the contents of vulvar malignancies in the field of traditional Chinese and Western medicine to provide reference for clinical work.Screening,diagnosis,staging,and treatment of vulvar malignancies,as well as the treatment of recurrent vulvar malignancies,other types of vulvar malignant tumors,nutritional therapy,and conditioning with traditional Chinese medicine are described.Result The incidence of vulvar malignancy is on the rise.There is no clear evidence to support routine screening for the prevention of vulvar malignancy.Vulvar malignancies is mainly treated with surgery.With the understanding of the biological behavior of vulvar malignancies,the surgical treatment mode has changed greatly,emphasizing individualized surgical treatment for early vulvar malignancies,while emphasizing the integrated treatment of surgery+radiotherapy+chemotherapy for locally advanced(or)advanced disease.In addition,it also includes recurrent vulvar cancer,other types of vulvar cancer,and traditional Chinese medicine treatment for vulvar cancer.Conclusion Clinically,different treatment options are provided for vulvar malignancies patients according to different stages.Treatment must be tailored to each patient based on the specific medical condition and other variables.展开更多
基金supported by the Natural Science Foundation of Hubei Province,China [Grant No.2017CKC891]the Health Commission Of Hubei Province,China [Grant No.WJ2019H286]
文摘Cervical cancer is a form of malignant tumor that seriously threatens women’s health. In China,according to the cancer statistics, 98,900 new cervical cancer cases and 30,500 deaths due to cervical cancer were estimated to have occurred in2015, and the incidence and mortality rates still exhibited an upward trend[1].
文摘Aims:Vanuatu is a lower-and middle-income country in the Pacific with a cervical cancer incidence of 100 per 100,000 women.An opportunistic screening program has existed since 2008,with continuous data collection related to this since 2015.Methods:We analysed al cervical cancer screening data for Vanuatu over 6 years,and conducted a descriptive analysis of number of women screened,the results of screening,the treatment rates of human papil omavirus(HPV)positivity or cytological abnormalities detected through screening,and the incidence of cervical cancer.The chal enges encountered during the implementation of the screening program are also described.Results:Data were available from 01/01/2015 to 31/12/2020.Based on census data,70,081 women were eligible for screening,and 15,696(22.4%)women underwent screening at least once.Screening coverage included 13.2%of individuals under 30 years,33.2%of individuals in the 30-50 age group,and 15.8%of people over 50 years.A total of 8910 HPV tests were conducted,of which 876(9.8%)were positive.Among the HPV-positive cases,316 received large loop excision of the transformation zone(LLETZ)treatment,156(49.4%)of which were high grade and 2(0.6%)of which were cancer.A total of 13,396 Pap smear tests were conducted,with 315(2.4%)showing high-grade results and 226(1.7%)indicating possible high-grade results.Overal,119 cancers were diagnosed from 15,696 women screened(0.8%),including 6/3297(0.2%)of<30 years,75/10,089(0.7%)of 30-50 years,38/2310(1.6%)of>50 years.Conclusion:One in five eligible Ni-Vanuatu women have undergone cervical cancer screening since 2015,with 7.6 per 1000 women having malignant results and 40.4 per 1000 women having high-grade or possible high-grade results.
基金supported by the National Key Research and Development Program (grant number:2021YFC2701202)。
文摘In response to the incidence of cervical intraepithelial neoplasia and cervical cancer in China and global screening strategies,a collaborative effort was undertaken by seven Chinese medical associations to develop this guideline for cervical cancer screening.The guideline recommends high-risk human papillomavirus(hr-HPV)testing as the preferred method for primary screening,which should have been approved by authoritative institutions and clinically validated for primary screening.In areas without access to HPV testing,cytology can be used as an alternative.However,it is recommended to replace cytology with HPV-based screening as conditions permit.Cotesting(HPV testing in combination with cytology)is recommended for areas with sufficient medical resources,opportunistic screening populations,and partial special populations.The guideline recommends that individuals with a cervix initiate cervical cancer screening at the age 25 years and undergo HPV testing alone or cotesting every five years,or cytology alone every three years.Women over the age of 65 who have had documented adequate negative prior screening in the past may terminate screening.Corresponding screening programs are proposed for different special populations.The development of these guidelines is an important step in the effort to eliminate cervical cancer in China.
文摘Background: The incidence of cervical cancer is high in Bangladesh and there is a high prevalence of preinvasive lower genital tract disease among women of reproductive age. Persistent high-risk Human Papilloma Virus (HPV) infection is the main underlying cause of cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN). Objective: The aim of the study was to identify the subtypes of high-risk HPV infection among women with the colposcopic diagnosis of cervical intraepithelial neoplasia in Bangladesh. Methods: This cross-sectional observational study was conducted in the colposcopy clinic of Dhaka Medical College Hospital over a six-month period. A total of 100 participants were enrolled. Married women, between 30 - 60 years of age with colposcopically diagnosed cervical intra epithelial neoplasia were enrolled. Women with chronic illness, pregnancy, and women unable to consent were excluded from this study. After counselling, colposcopically directed punch biopsies were taken from each CIN case concurrently with high-risk HPV testing by polymerase chain reaction (PCR). Results: The mean age of the patients was 38.69 (SD ±7.76) years. CIN 1 was diagnosed in 57% of participants, while 24% had CIN II and 19% had CIN III lesions. High-risk HPV was present in 52 patients. HPV 16 was the most common identified in 28 (53.84%) and HPV 18 was the second most common with 20 (38.46%) either singly or in combination with other high-risk subtypes. The other HPV strains, HPV 31, 33, 35, 52, 56 and 58, were also detected either as mono or co-infections. Out of the 52 HPV positive cases, 29 (55.8%) had mono infection and 23 (44.2%) had co-infection with several subtypes. The highest incidence (50%) of oncogenic HPV infections was present among women aged 35 - 45 years. Risk factors associated with HPV positive cases were high parity (P 0.05), early age at marriage (P = 0.754) and early age of first child. Conclusion: This study identified a high prevalence of HPV 16 and 18 genotypes. HPV vaccination with the current 9-valent HPV vaccine, which contains HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. Will be an effective public health measure to eradicate cervical cancer in Bangladesh.
文摘Objective: To acquire a ribozyme against the E6 gene of human papillomaviruses type 16 (HPV16E6) and investigate its effects on the phenotypes and gene expression of cervical cancer cell line. Methods: Anti-HPV16E6 ribozyme (HRz) was designed by computer programs and its activity identified by cleavage experiment in vitro before its transfection via lipofectin into CaSKi cells with the empty eucaryotic expression plasmid transfection of the cells also performed, the resultant cells designated as CaSKi-R, CaSKi-P respectively. The morphology and the soft agar forming ability were studied in CaSKi cells and the transfected cells, and the expression of E6, proliferating cell nuclear antigen (PCNA) and C-erbB-2 genes assayed by flow cytometry. The tumorgenicity of each cell line was evaluated in nude mice receiving inoculations of CaSKi, CaSKi-R and CaSKi-P cells separately, while in one group, both CaSKi and CaSKi-R cells were inoculated on different sides of the mice. Results: HRz was able to cleave HPV16E6 mRNA in a site-specific manner and could be expressed stably in transfected CaSKi cells. Northern blot analysis showed that E6 mRNA was less in CaSKi-R than in CaSKi cells, and no significant difference in the morphology and growth rate was observed between CaSKi and CaSKi-P cells, but the growth rate CaSKi-R was lowered. The colony-forming rate of CaSKi-P in soft agar was similar to that of CaSKi cells, while that of CaSKi-R was decreased. Flow cytometry showed that anti-HPV16E6 ribozyme reduced the expression of E6, PCNA and C-erbB-2 genes in CaSKi-R cells, but not in CaSKi-P cells. The tumorgenicity of CaSKi-R in nude mice was decreased compared with CaSKi cells. Conclusion: HRz can partially reverse the malignant phenotype of CaSKi cells, possibly due to decreased E6 gene expression, and the consequent decrease of PCNA and C-erbB-2 gene expressions.
基金This work was supported by the Natural Science Foundation of Hubei Province, China (No.2017CKC891).
文摘High-risk human papillomavirus (hrHPV) infection plays an important role in the development of cervical intraepithelial neoplasia and cervical cancer.A total of 11 549 women were enrolled from the Maternal and Child Health Hospital of Hubei Province.Each participant accepted hrHPV testing and completed a self^administered questionnaire about basic information and potential risk factors.The univariable and multivariable logistic regression model was used to explore the associations between variants and hrHPV infection.Our results showed that hrHPV prevalence was 16.09% in Hubei Province,among which,hrHPV was more likely to be positive in women aged 51 years or above (OR=1.65,95% CI:1.28-2.14),and in women who had symptoms of bleeding after intercourse (OR=1.32,95% CI:1.17-1.50),had first sexual intercourse at the age of 18 years or below (OR=1.33,95% CI:1.07-1.64),had at least three male sexual partners (OR=2.50,95% CI:2.07-3.03),and who had been diagnosed with sexually transmitted infections (OR=1.50,95% CI:1.12-2.03).Married women (OR=0.66,95% CI:0.55-0.78) and women who frequently used condoms (OR=0.75,95% CI:0.67-0.84) had a relatively lower hrHPV prevalence.This study confirms that hrHPV infection was associated with age,marital status,symptoms of intercourse bleeding,history of sexually transmitted infections,and sex-related behaviors.Above all,this study provides a baseline database prior to obtaining vaccinations for dynamic tracking of the changes in hrHPV prevalence.
文摘Objective: To explore the predictors of intermediate endpoints of cervical cancer in 500 women living in Porto Alegre. Study design: Five hundred randomly selected women (mean age 20.3 years, range 15-25) were screened using PCR detecting 25 HPV types (HPV6, 11, 16, 18, 31, 33, 34, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 66, 68, 70, and 74)-. Women were interviewed and serum samples were analysed for antibodies to HPV16 and HPV18 VLPs. Regression models were constructed to analyse predictive factors for (a) HPV PCR status, (b)HPV16-seropositivity,(c)HPV18-seropositivity, and (d) SIL in the PAP smear, used as intermediate endpoints of cervical cancer. Results: Specific HPV types were identified in 137 (27.4%) of the 157 (31.4%) PCR-positive women. PAP test result was the most powerful independent predictor of HPV status in PCR (p = 0.0001), followed by the sexual activity started (p = 0.001) (adjusted OR 34.075, 95%CI: 4.650-249.715). PAP test SIL was independently predicted only by the HPV PCR status (p = 0.0001) (OR 7.561, 95%CI: 2.787-20.514). HPV16 and HPV18 serostatus were the most significant predictors of each other (p = 0.0001), and the life-time number of sexual partners was more significant (p = 0.001) predictor of HPV16 than HPV18 serostatus (p = 0.049). Conclusion: These data are useful in evaluating the exposure status of the women to the risk factors of cervical cancer in south of Brazil.
文摘Objective The purpose of this study is to provide reference and guidance for the clinical diagnosis and treatment of vulvar malignancies.Method This article sorts out and integrates the contents of vulvar malignancies in the field of traditional Chinese and Western medicine to provide reference for clinical work.Screening,diagnosis,staging,and treatment of vulvar malignancies,as well as the treatment of recurrent vulvar malignancies,other types of vulvar malignant tumors,nutritional therapy,and conditioning with traditional Chinese medicine are described.Result The incidence of vulvar malignancy is on the rise.There is no clear evidence to support routine screening for the prevention of vulvar malignancy.Vulvar malignancies is mainly treated with surgery.With the understanding of the biological behavior of vulvar malignancies,the surgical treatment mode has changed greatly,emphasizing individualized surgical treatment for early vulvar malignancies,while emphasizing the integrated treatment of surgery+radiotherapy+chemotherapy for locally advanced(or)advanced disease.In addition,it also includes recurrent vulvar cancer,other types of vulvar cancer,and traditional Chinese medicine treatment for vulvar cancer.Conclusion Clinically,different treatment options are provided for vulvar malignancies patients according to different stages.Treatment must be tailored to each patient based on the specific medical condition and other variables.
