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
AIM:To assess the prevalence of human papilloma virus(HPV) in esophageal squamous cell carcinoma(ESCC) in the south-eastern region of Poland.METHODS:The study population consisted of 56 ESCC patients and 35 controls.T...AIM:To assess the prevalence of human papilloma virus(HPV) in esophageal squamous cell carcinoma(ESCC) in the south-eastern region of Poland.METHODS:The study population consisted of 56 ESCC patients and 35 controls.The controls were patients referred to our department due to other nonesophageal and non-oncological disorders with no gross or microscopic esophageal pathology as confirmed by endoscopy and histopathology.In the ESCC patients,samples were taken from normal mucosa(56 mucosa samples) and from the tumor(56 tumor samples).Tissue samples from the controls were taken from normal mucosa of the middle esophagus(35 control samples).Quantitative determination of DNA was carried out using a spectrophotometric method.Genomic DNA was isolated using the QIAamp DNA Midi Kit.HPV infection was identified following PCR amplification of the HPV gene sequence,using primers MY09 and MY11 complementary to the genome sequence of at least 33 types of HPV.The sequencing results were computationally analyzed using the basic local alignment search tool database.RESULTS:In tumor samples,HPV DNA was identified in 28 of 56 patients(50%).High risk HPV phenotypes(16 or/and 18) were found in 5 of 56 patients(8.9%),low risk in 19 of 56 patients(33.9%) and other types of HPV(37,81,97,CP6108) in 4 of 56 patients(7.1%).In mucosa samples,HPV DNA was isolated in 21 of 56 patients(37.5%).High risk HPV DNA was confirmed in 3 of 56 patients(5.3%),low risk HPV DNA in 12 of 56 patients(21.4%),and other types of HPV in 6 of 56 patients(10.7%).In control samples,HPV DNA was identified in 4 of 35 patients(11.4%) with no high risk HPV.The occurrence of HPV in ESCC patients was significantly higher than in the controls [28 of 56(50%) vs 4 of 35(11.4%),P < 0.001].In esophageal cancer patients,both in tumor and mucosa samples,the predominant HPV phenotypes were low risk HPV,isolated 4 times more frequently than high risk phenotypes [19 of 56(33.9%) vs 5 of 56(8.9%),P < 0.001].A higher prevalence of HPV was identified in female patients(71.4% vs 46.9%).Accordingly,the high risk phenotypes were isolated more frequently in female patients and this difference reached statistical significance [3 of 7(42.9%) vs 2 of 49(4.1%),P < 0.05].Of the pathological characteristics,only an infiltrative pattern of macroscopic tumor type significantly correlated with the presence of HPV DNA in ESCC samples [20 of 27(74.1%) vs 8 of 29(27.6%) for ulcerative or protruding macroscopic type,P < 0.05].The occurrence of total HPV DNA and both HPV high or low risk phenotypes did not significantly differ with regard to particular grades of cellular differentiation,phases in depth of tumor infiltration,grades of nodal involvement and stages of tumor progression.CONCLUSION:Low risk HPV phenotypes could be one of the co-activators or/and co-carcinogens in complex,progressive,multifactorial and multistep esophageal carcinogenesis.展开更多
Cervical lesions have been regarded as the common and frequently occurring diseases in China.Recently,the morbidity and youth tendency of cervical cancer have gradually increased.Cervical cancer,related with human pap...Cervical lesions have been regarded as the common and frequently occurring diseases in China.Recently,the morbidity and youth tendency of cervical cancer have gradually increased.Cervical cancer,related with human papilloma virus(HPV)infection,has been one of the severest diseases threatening health and life of women,and is an infectious disease.The universality of HPV infection in the reproductive tract should not be ignored.The well-known risk factors of HPV infection in cervical lesions consist of high-risk sexual behaviors,immunosuppression,age,contraceptive methods,the concurrent infection of other sexually transmitted diseases,etc.The variation of cervical lesions induced by HPV infection is involved in the continuous pathological process,including the subclinical,latent,and persistent infection of high risk(HR)-HPV,chronic cervicitis with abnormal results of cytological examination,cervical intraepithelial neoplasia(CIN),and cervical cancer.The outcome of patients with HPV infection is influenced by many factors,such as HPV subtype dominance,persistent HPV infection,HPV loading dose,and multiple HPV infection.Controlling HR-HPV persistent infection should be an important strategy for reducing cervical lesions.展开更多
目的:探讨宫颈锥切术联合三元融合蛋白(MBP-SERPINA-IFNκ,MSIK)治疗宫颈高级别鳞状上皮内病变(high-grade cervical lesions,HSIL)合并高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染的临床效果。方法:选取2019年08月...目的:探讨宫颈锥切术联合三元融合蛋白(MBP-SERPINA-IFNκ,MSIK)治疗宫颈高级别鳞状上皮内病变(high-grade cervical lesions,HSIL)合并高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染的临床效果。方法:选取2019年08月至2021年07月我院收治的186例HSIL患者,采用随机数字表法分为MSIK组(n=93)和对照组(n=93),两组均接受宫颈锥切术治疗,对照组术后非经期阴道推入干扰素α-2β凝胶,隔日一次,10次/疗程,MSIK组术后非经期阴道推入MSIK,14 d/疗程,均治疗3个疗程。比较两组患者治疗前后不同时间点TCT异常率及HR-HPV转阴率,比较两组治疗前后临床症状评分改变、治疗期间不良反应,比较两组治愈率及复发率。结果:随访期间两组HR-HPV转阴率呈升高趋势,且随访9、12个月两组HR-HPV转阴率均较随访3个月时升高(P<0.05);随访3、6、9、12个月时,MSIK组HR-HPV转阴率均高于对照组(P<0.05)。随访3、6、9、12个月,两组TCT异常率均明显低于治疗前,且MSIK组低于对照组(P<0.05)。治疗后两组临床症状评分较治疗前降低,且MSIK组更低(P<0.05)。MSIK治疗期间不良反应发生率为3.23%,低于对照组的10.75%(P<0.05)。MSIK组治愈率为97.85%,高于对照组的81.72%(P<0.05);随访12个月MSIK组无复发情况,与对照组复发率比较差异有统计学意义(P<0.05)。结论:宫颈锥切术联合MSIK治疗HSIL合并HR-HPV感染可有效提高转阴率,且治疗效果确切、复发率低,值得临床推广。展开更多
目的:分析宫颈高危型人乳头瘤病毒(high risk human papilloma virus,HR-HPV)感染患者中医体质类型分布特点,为中医药调理体质防治宫颈HR-HPV感染提供依据。方法:选择2019年1月至2020年12月就诊于河南中医药大学第一附属医院妇科门诊及...目的:分析宫颈高危型人乳头瘤病毒(high risk human papilloma virus,HR-HPV)感染患者中医体质类型分布特点,为中医药调理体质防治宫颈HR-HPV感染提供依据。方法:选择2019年1月至2020年12月就诊于河南中医药大学第一附属医院妇科门诊及体检中心的420例宫颈HR-HPV感染者作为观察组,选择420例同时段宫颈HR-HPV检测阴性者为对照组。分析两组中医体质类型分布情况、观察组不同年龄段中医体质类型分布情况、观察组不同HR-HPV基因型别中医体质类型。结果:观察组中医体质分布依次为:痰湿质(30.50%)>湿热质(19.00%)>平和质(15.50%)>阳虚质(14.80%)>气虚质(10.00%)>阴虚质(5.90%)>瘀血质(2.70%)>气郁质(1.70%);对照组中医体质分布依次为:平和质(73.30%)>湿热质(8.40%)>阴虚质(5.70%)>痰湿质(4.50%)>气虚质(4.30%)>阳虚质/瘀血质(1.80%)>气郁质(0.20%)。两组中医体质类型比较,差异具有统计学意义(P<0.05),其中,痰湿质、湿热质、阳虚质、气虚质,两组间比较,差异具有统计学意义(P<0.001)。观察组体质类型居前三位的是痰湿质、湿热质、阳虚质,占全部体质类型的64.30%。对照组平和质324例,占比73.50%,观察组平和质81例,占比15.50%,两组间比较,差异具有统计学意义(P<0.001)。观察组中,痰湿质、阳虚质、阴虚质主要见于46~55岁,湿热质、气虚质、气郁质主要见于36~45岁,组间比较差异具有统计学意义(P<0.05)。两组宫颈HR-HPV16、18型和非16、18型中医体质比较,差异无统计学意义(P>0.05)。结论:痰湿质、湿热质、阳虚质为宫颈HR-HPV感染人群的易感体质;痰湿质、湿热质、阳虚质与年龄具有相关性,痰湿质多见于36~45岁,湿热质、阳虚质多见于46~55岁,HR-HPV基因型别与中医体质类型之间无明显相关性。展开更多
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.
基金Supported by Medical University of Lublin,Scientific Research Grant
文摘AIM:To assess the prevalence of human papilloma virus(HPV) in esophageal squamous cell carcinoma(ESCC) in the south-eastern region of Poland.METHODS:The study population consisted of 56 ESCC patients and 35 controls.The controls were patients referred to our department due to other nonesophageal and non-oncological disorders with no gross or microscopic esophageal pathology as confirmed by endoscopy and histopathology.In the ESCC patients,samples were taken from normal mucosa(56 mucosa samples) and from the tumor(56 tumor samples).Tissue samples from the controls were taken from normal mucosa of the middle esophagus(35 control samples).Quantitative determination of DNA was carried out using a spectrophotometric method.Genomic DNA was isolated using the QIAamp DNA Midi Kit.HPV infection was identified following PCR amplification of the HPV gene sequence,using primers MY09 and MY11 complementary to the genome sequence of at least 33 types of HPV.The sequencing results were computationally analyzed using the basic local alignment search tool database.RESULTS:In tumor samples,HPV DNA was identified in 28 of 56 patients(50%).High risk HPV phenotypes(16 or/and 18) were found in 5 of 56 patients(8.9%),low risk in 19 of 56 patients(33.9%) and other types of HPV(37,81,97,CP6108) in 4 of 56 patients(7.1%).In mucosa samples,HPV DNA was isolated in 21 of 56 patients(37.5%).High risk HPV DNA was confirmed in 3 of 56 patients(5.3%),low risk HPV DNA in 12 of 56 patients(21.4%),and other types of HPV in 6 of 56 patients(10.7%).In control samples,HPV DNA was identified in 4 of 35 patients(11.4%) with no high risk HPV.The occurrence of HPV in ESCC patients was significantly higher than in the controls [28 of 56(50%) vs 4 of 35(11.4%),P < 0.001].In esophageal cancer patients,both in tumor and mucosa samples,the predominant HPV phenotypes were low risk HPV,isolated 4 times more frequently than high risk phenotypes [19 of 56(33.9%) vs 5 of 56(8.9%),P < 0.001].A higher prevalence of HPV was identified in female patients(71.4% vs 46.9%).Accordingly,the high risk phenotypes were isolated more frequently in female patients and this difference reached statistical significance [3 of 7(42.9%) vs 2 of 49(4.1%),P < 0.05].Of the pathological characteristics,only an infiltrative pattern of macroscopic tumor type significantly correlated with the presence of HPV DNA in ESCC samples [20 of 27(74.1%) vs 8 of 29(27.6%) for ulcerative or protruding macroscopic type,P < 0.05].The occurrence of total HPV DNA and both HPV high or low risk phenotypes did not significantly differ with regard to particular grades of cellular differentiation,phases in depth of tumor infiltration,grades of nodal involvement and stages of tumor progression.CONCLUSION:Low risk HPV phenotypes could be one of the co-activators or/and co-carcinogens in complex,progressive,multifactorial and multistep esophageal carcinogenesis.
基金supported by the Special Funds for State Key Development Program for Basic Research of China(973 Program)(No.2009CB521800)the National Natural Science Foundation of China(Grant Nos.30672227,30770913,30628029,30500596 and 30600667).
文摘Cervical lesions have been regarded as the common and frequently occurring diseases in China.Recently,the morbidity and youth tendency of cervical cancer have gradually increased.Cervical cancer,related with human papilloma virus(HPV)infection,has been one of the severest diseases threatening health and life of women,and is an infectious disease.The universality of HPV infection in the reproductive tract should not be ignored.The well-known risk factors of HPV infection in cervical lesions consist of high-risk sexual behaviors,immunosuppression,age,contraceptive methods,the concurrent infection of other sexually transmitted diseases,etc.The variation of cervical lesions induced by HPV infection is involved in the continuous pathological process,including the subclinical,latent,and persistent infection of high risk(HR)-HPV,chronic cervicitis with abnormal results of cytological examination,cervical intraepithelial neoplasia(CIN),and cervical cancer.The outcome of patients with HPV infection is influenced by many factors,such as HPV subtype dominance,persistent HPV infection,HPV loading dose,and multiple HPV infection.Controlling HR-HPV persistent infection should be an important strategy for reducing cervical lesions.
文摘目的:分析宫颈高危型人乳头瘤病毒(high risk human papilloma virus,HR-HPV)感染患者中医体质类型分布特点,为中医药调理体质防治宫颈HR-HPV感染提供依据。方法:选择2019年1月至2020年12月就诊于河南中医药大学第一附属医院妇科门诊及体检中心的420例宫颈HR-HPV感染者作为观察组,选择420例同时段宫颈HR-HPV检测阴性者为对照组。分析两组中医体质类型分布情况、观察组不同年龄段中医体质类型分布情况、观察组不同HR-HPV基因型别中医体质类型。结果:观察组中医体质分布依次为:痰湿质(30.50%)>湿热质(19.00%)>平和质(15.50%)>阳虚质(14.80%)>气虚质(10.00%)>阴虚质(5.90%)>瘀血质(2.70%)>气郁质(1.70%);对照组中医体质分布依次为:平和质(73.30%)>湿热质(8.40%)>阴虚质(5.70%)>痰湿质(4.50%)>气虚质(4.30%)>阳虚质/瘀血质(1.80%)>气郁质(0.20%)。两组中医体质类型比较,差异具有统计学意义(P<0.05),其中,痰湿质、湿热质、阳虚质、气虚质,两组间比较,差异具有统计学意义(P<0.001)。观察组体质类型居前三位的是痰湿质、湿热质、阳虚质,占全部体质类型的64.30%。对照组平和质324例,占比73.50%,观察组平和质81例,占比15.50%,两组间比较,差异具有统计学意义(P<0.001)。观察组中,痰湿质、阳虚质、阴虚质主要见于46~55岁,湿热质、气虚质、气郁质主要见于36~45岁,组间比较差异具有统计学意义(P<0.05)。两组宫颈HR-HPV16、18型和非16、18型中医体质比较,差异无统计学意义(P>0.05)。结论:痰湿质、湿热质、阳虚质为宫颈HR-HPV感染人群的易感体质;痰湿质、湿热质、阳虚质与年龄具有相关性,痰湿质多见于36~45岁,湿热质、阳虚质多见于46~55岁,HR-HPV基因型别与中医体质类型之间无明显相关性。