Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introdu...Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.展开更多
Maternal hypoglycemia,a condition characterized by lower than normal blood glucose levels in pregnant women,has been increasingly associated with adverse pregnancy outcomes,including low birth weight(LBW)in neonates.L...Maternal hypoglycemia,a condition characterized by lower than normal blood glucose levels in pregnant women,has been increasingly associated with adverse pregnancy outcomes,including low birth weight(LBW)in neonates.LBW,defined as a birth weight of less than 2500 g,can result from various factors,including maternal nutrition,health status,and metabolic conditions like hypoglycemia.Maternal hypoglycemia may affect fetal growth by altering the supply of essential nutrients and oxygen to the fetus,leading to restricted fetal development and growth.This condition poses significant risks not only during pregnancy but also for the long-term health of the child,increasing the likelihood of developmental delays,health issues,and chronic conditions later in life.Research in this area has focused on understanding the mechanisms through which maternal hypoglycemia influences fetal development,with studies suggesting that alterations in placental blood flow and nutrient transport,as well as direct effects on fetal insulin levels and metabolism,may play a role.Given the potential impact of maternal hypoglycemia on neonatal health outcomes,early detection and management are crucial to minimize risks for LBW and its associated complications.Further investigations are needed to fully elucidate the complex interactions between maternal glucose levels and fetal growth,as well as to develop targeted interventions to support the health of both mother and child.Understanding these relationships is vital for improving prenatal care and outcomes for pregnancies complicated by hypoglycemia.展开更多
Background: Incorporation of HPV tests into cervical cancer screening programs may be advantageous over conventional cytology, especially in developing nations, where the largest burden of cervical cancer is observed....Background: Incorporation of HPV tests into cervical cancer screening programs may be advantageous over conventional cytology, especially in developing nations, where the largest burden of cervical cancer is observed. Objectives: To conduct an evaluation of commercially available molecular HPV tests in Brazilian women. Study design: Two groups were recruited: group A was composed of 511 women referred to the clinics because of a previous abnormal Pap test while group B consisted of 2464 subjects under routine screening. Cervical samples were collected using SurePath liquid cytology (LBC) device, and split into aliquots which were submitted to molecular testing by Hybrid Capture and cobas HPV. Colposcopy and biopsies were made according to the standard guidelines, directed by cytological diagnosis. Results: Prevalence of HSIL was 5.97% and 0.7% in Group A and B respectively. High-Risk HPV DNA was found in about 9% of group B women, while in group A this frequency was 24%. Having CIN3+ as the study end-point, the negative predictive values for molecular methods were above 99.8%. All “in-situ” and invasive cervical carcinomas were detected by both HPV nucleic acid assays. Conclusion: Use of HPV DNA testing was feasible and highly sensitive in cancer screening settings of Brazil.展开更多
Objective:To study the relationship between the infection of high-risk HPV in cervical precancerous lesion and the expression of oncogene, anti-oncogene.Methods:218 cases ofcervical intraepithelial neoplasia patients ...Objective:To study the relationship between the infection of high-risk HPV in cervical precancerous lesion and the expression of oncogene, anti-oncogene.Methods:218 cases ofcervical intraepithelial neoplasia patients in our hospital during May 2014–May 2016 were chosed and divided into high-risk HPV group (n=107), low-risk HPV group (n=111) according to cervical tissue HPV test;another 100 cases of patients received cervical biopsy and confirmed as benign lesions were enrolled in the control group. RT-PCR method was used to detect the mRNA expression of proto-oncogene and anti-oncogene in three groups, Western-blot method was used to detect the protein expression of Sox-2 and Wnt/β-catenin signal pathway.Results: mRNA expression of oncogene DEK, Bmi-1, c-fos, K-ras, Prdx4 in high-risk HPV group were higher than low-risk HPV group and control group (P<0.05);mRNA expression of anti-oncogene P27, P16, DAPK, PTEN, eIF4E3 in high-risk HPV group were lower than low-risk HPV group and control group (P<0.05);expression of Sox-2 and Wnt/β-catenin signaling pathway protein Sox-2,β-catenin, wnt-1, wnt-3a in high-risk HPV group were higher than low-risk HPV group and control group (P<0.05).Conclusions:High-risk HPV infection can increase the expression of oncogenes and reduce the expression of anti-oncogenes in cervical dysplasia tissues on Sox-2- and Wnt/β-catenin signaling pathway manners.展开更多
We submitted 437 patients with cytological alterations that suggest viral infections to HPV test. 154 patients (35.24%) resulted positive for HPV;among these, 128 (83.11%) with a low degree of infectivity, 19 (12.33%)...We submitted 437 patients with cytological alterations that suggest viral infections to HPV test. 154 patients (35.24%) resulted positive for HPV;among these, 128 (83.11%) with a low degree of infectivity, 19 (12.33%), with an average degree of infectivity and 7 (4.54%) with a high degree of infectivity).展开更多
Objective:This study conducted a systematic review of randomized controlled trials in order to evaluate the efficacy and safety of Baofukang Suppository(保妇康栓)combined with interferon on cervical high-risk human pa...Objective:This study conducted a systematic review of randomized controlled trials in order to evaluate the efficacy and safety of Baofukang Suppository(保妇康栓)combined with interferon on cervical high-risk human papillomavirus(HR-HPV)infection.Methods:Data comes from China National Knowledge Infrastructure(CNKI),Wanfang database,the VIP information database,Chinese Biomedical Literature Database,PubMed,Cochrane Library,Web of Science and Embase.Primary and secondary outcome measures were extracted from 13 included randomized controlled trials:number of HR-HPV turning negative and effective,time of HPV turning negative,duration of abnormal vaginal secretions and adverse events.Results:Baofukang Suppository combined with interferon were better than interferon alone in improving the negative rate of HR-HPV(RR=1.42,95%CI[1.28,1.58],P<0.00001)and the effective rate of HR-HPV RR=1.3,95%CI[1.24,1.37],P<0.00001),time of HR-HPV turning negative(MD=-8.32,95%CI[-9.17,-7.47],P<0.00001),duration of abnormal vaginal secretions(MD=-8.95,95%CI[-11.34,-6.56],P<0.00001).However,there was no statistical difference in improving inflammatory factor(TNF-α:SMD=-0.49,95%CI[-1.02,0.03],Z=1.83,P=0.07;IL-6:SMD=-13.69,95%CI[-41.98,14.6],Z=0.95,P=0.34)and adverse events(RR=-0.73,95%CI[0.48,1.11,P=0.15)between two groups.Conclusion:The results showed that the efficacy of Baofukang Suppository combined with interferon were better than interferon alone in improving the negative and effective rate of HR-HPV,shortening the time of HR-HPV turning negative and duration of abnormal vaginal secretion and reducing adverse events.展开更多
Objective:To study the relationship of high-risk human papilloma virus (HPV) infection with mitogen-activated protein kinase/extracellular signal-regulated kinase 3 (MEKK3) and nuclear factorκB (NF-κB) expression in...Objective:To study the relationship of high-risk human papilloma virus (HPV) infection with mitogen-activated protein kinase/extracellular signal-regulated kinase 3 (MEKK3) and nuclear factorκB (NF-κB) expression in cervical intraepithelial neoplasia tissue.Methods:125 cases of cervical biopsy specimens between May 2013 and March 2016 were collected. The cervical inflammation specimens, cervical intraepithelial neoplasia specimens and cervical cancer specimens were included in inflammation group, CIN group and malignant group respectively. HPV-DNA typing detection kits were used to determine HPV typing, immunohistochemical kits were used to determine MEKK3 and NF-κB protein expression, and fluorescent quantitative PCR kits were used to determine the mRNA expression of MEKK3, NF-κB and downstream molecules.Results: MEKK3 and NF-κB protein expression in high-risk HPV-positive cervical tissue were significantly higher than those in high-risk HPV-negative cervical tissue (P<0.05), and MEKK3, NF-κB, Bcl-2, XIAP, Bmi-1, TGF-β and Vimentin mRNA expression in high-risk type HPV-positive cervical tissue were significantly higher than those in high-risk HPV-negative cervical tissue (P<0.05);Bcl-2, XIAP, Bmi-1, TGF-β and Vimentin mRNA expression in tissue with positive MEKK3 and NF-κB expression were significantly higher than those in tissue with negative MEKK3 and NF-κB expression (P<0.05).Conclusions:High-risk HPV infection will increase the expression of proliferation genes Bcl-2, XIAP and Bmi-1 as well as invasion genes TGF-β and Vimentin in cervical intraepithelial neoplasia tissue through MEKK3/NF-κB pathway.展开更多
Objectives: To identify the obstacles and issues that hinder effective cancer prevention efforts in Ukraine. The study aims to provide a comprehensive assessment of the barriers to cancer prevention, including both in...Objectives: To identify the obstacles and issues that hinder effective cancer prevention efforts in Ukraine. The study aims to provide a comprehensive assessment of the barriers to cancer prevention, including both infrastructure and behavioral factors, and identify potential solutions to address these challenges. Study Design: Comprehensive literature review. Methods: The following databases were searched: National Center for Biotechnology Information (NCBI) and PubMed (U.S. National Library of Medicine at the National Institutes of Health). The keywords used in the search included “Cervical Cancer”, “Human Papillomavirus Vaccination (HPV)”, “Ukraine”, “Eastern Europe”, “Healthcare Infrastructure in Disasters”, “Cervical Cancer Prevention”, “Pap Smear”, and “HPV Testing”. Results: A total of 3500 articles were screened. A total of 65 articles met the inclusion criteria. Limited public awareness and limited access to vaccination and screening, combined with inadequate treatment facilities lead to higher rates of cervical cancer. The COVID pandemic, war with Russia, and the Chernobyl disaster are significant factors for the low level of vaccination in Ukraine. Conclusion: The prevention and treatment of cervical cancer in Ukraine face significant challenges due to the inadequate HPV vaccination rates and screening by cytology. Efforts to improve funding and increase education of both the population and health care providers are necessary to increase interventions such as HPV vaccination, cervical cytology, and HPV testing to reduce cervical cancer rates in Ukraine.展开更多
Purpose: To understand the application of high-risk HPV detection combined with cervical cytology, colposcopy and pathology in cervical lesions of women in Tiandeng County. Method: Women in the outpatient and inpatien...Purpose: To understand the application of high-risk HPV detection combined with cervical cytology, colposcopy and pathology in cervical lesions of women in Tiandeng County. Method: Women in the outpatient and inpatient departments of our hospital from January 2021 to October 2022 were collected for high-risk HPV testing, TCT, colposcopy and pathological examination according to their personal wishes, to understand the application of relevant examinations in cervical lesions. Result: In 2021, the number of patients was 5801, among whom 1743 patients had received cervical cancer examination in the past, accounting for 30.05% of the total number of patients, and 5795 who had volunteered for TCT examination this time, accounting for 99.90% of the total;A total of 289 cases of atypical squamous cells with unclear significance (ASC-US) were detected, excluding 11 cases of high-grade squamous intraepithelial lesions (ASC-H), 122 cases of low-grade squamous intraepithelial lesions (LSIL), 16 cases of high-grade squamous intraepithelial lesions (HSIL), 2 cases of squamous cell carcinoma (SCC), and 4 cases of atypical adenocyte (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of people who volunteered for high-risk HPV testing was 4237, and the number of positive cases was 740, accounting for 17.47% of the screening population;Among 740 HPV-positive patients, 488 high-risk HPV-positive patients were selected for TCT examination, and 87 patients were found to be TCT positive;From 401 high-risk HPV-positive and TCT negative patients, 287 patients with possible lesions were screened out for colposcopy;The results showed that 60 patients may have certain cervical lesions and need further pathological examination and the results showed that 28 patients had CTN1 and 18 patients had CIN2 - 3. In 2022, 8840 patients received medical treatment, among which 3188 patients had received cervical cancer examination in the past, accounting for 36.06% of the total number of patients, and 8314 patients voluntarily underwent TCT examination, accounting for 94.05% of the total number of patients. 434 cases of atypical squamous cells with ambiguous meaning (ASC-US) were detected, excluding 13 cases of high-grade squamous intraepithelial lesions (ASC-H), 217 cases of low-grade squamous intraepithelial lesions (LSIL), 35 cases of high-grade squamous intraepithelial lesions (HSIL), 1 case of squamous cell carcinoma, and 4 cases of atypical adenocarcinoma (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of volunteers for high-risk HPV testing was 3871 cases, and the number of positive cases was 654 cases, accounting for 16.89% of the screening number. 527 high-risk HPV-positive patients were selected from 654 HPV-positive patients for TCT examination, and the number of TCT-positive patients was found to be 49. From 478 high-risk HPV-positive patients with TCT negative, 276 patients with possible lesions were screened out for colposcopy;The results showed that 66 patients may have certain cervical lesions and need further pathological examination;and then the results showed that 31 cases of CTN1 and 6 cases of CIN2 - 3. Conclusion: Gynecological high-risk HPV examination can provide better etiological sources for cervical cancer screening;Cervical cytology examination has high sensitivity;Colposcopy examination has high specificity;Pathological examination can be used as an effective supplement for cervical cytology examination and colposcopy;So high-risk HPV combined with cytology examination, colposcopy examination and pathological examination has high clinical application value;It is worth popularizing and applying.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
文摘Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.
文摘Maternal hypoglycemia,a condition characterized by lower than normal blood glucose levels in pregnant women,has been increasingly associated with adverse pregnancy outcomes,including low birth weight(LBW)in neonates.LBW,defined as a birth weight of less than 2500 g,can result from various factors,including maternal nutrition,health status,and metabolic conditions like hypoglycemia.Maternal hypoglycemia may affect fetal growth by altering the supply of essential nutrients and oxygen to the fetus,leading to restricted fetal development and growth.This condition poses significant risks not only during pregnancy but also for the long-term health of the child,increasing the likelihood of developmental delays,health issues,and chronic conditions later in life.Research in this area has focused on understanding the mechanisms through which maternal hypoglycemia influences fetal development,with studies suggesting that alterations in placental blood flow and nutrient transport,as well as direct effects on fetal insulin levels and metabolism,may play a role.Given the potential impact of maternal hypoglycemia on neonatal health outcomes,early detection and management are crucial to minimize risks for LBW and its associated complications.Further investigations are needed to fully elucidate the complex interactions between maternal glucose levels and fetal growth,as well as to develop targeted interventions to support the health of both mother and child.Understanding these relationships is vital for improving prenatal care and outcomes for pregnancies complicated by hypoglycemia.
基金This study was supported by research funds granted to the INCT-HPV(www.hpv.org.br)by the Conselho Nacional de Pesquisas(CNPq,Grant#573799/2008-3) Fundacao de Amparo a Pesquisa do Estado de Sao Paulo(FAPESP,Grant#2008/57889-1)All commercial tests employed were purchased by the INCT-HPV.Companies didn’t have any role in the study design,data evaluation or manuscript writing.
文摘Background: Incorporation of HPV tests into cervical cancer screening programs may be advantageous over conventional cytology, especially in developing nations, where the largest burden of cervical cancer is observed. Objectives: To conduct an evaluation of commercially available molecular HPV tests in Brazilian women. Study design: Two groups were recruited: group A was composed of 511 women referred to the clinics because of a previous abnormal Pap test while group B consisted of 2464 subjects under routine screening. Cervical samples were collected using SurePath liquid cytology (LBC) device, and split into aliquots which were submitted to molecular testing by Hybrid Capture and cobas HPV. Colposcopy and biopsies were made according to the standard guidelines, directed by cytological diagnosis. Results: Prevalence of HSIL was 5.97% and 0.7% in Group A and B respectively. High-Risk HPV DNA was found in about 9% of group B women, while in group A this frequency was 24%. Having CIN3+ as the study end-point, the negative predictive values for molecular methods were above 99.8%. All “in-situ” and invasive cervical carcinomas were detected by both HPV nucleic acid assays. Conclusion: Use of HPV DNA testing was feasible and highly sensitive in cancer screening settings of Brazil.
文摘Objective:To study the relationship between the infection of high-risk HPV in cervical precancerous lesion and the expression of oncogene, anti-oncogene.Methods:218 cases ofcervical intraepithelial neoplasia patients in our hospital during May 2014–May 2016 were chosed and divided into high-risk HPV group (n=107), low-risk HPV group (n=111) according to cervical tissue HPV test;another 100 cases of patients received cervical biopsy and confirmed as benign lesions were enrolled in the control group. RT-PCR method was used to detect the mRNA expression of proto-oncogene and anti-oncogene in three groups, Western-blot method was used to detect the protein expression of Sox-2 and Wnt/β-catenin signal pathway.Results: mRNA expression of oncogene DEK, Bmi-1, c-fos, K-ras, Prdx4 in high-risk HPV group were higher than low-risk HPV group and control group (P<0.05);mRNA expression of anti-oncogene P27, P16, DAPK, PTEN, eIF4E3 in high-risk HPV group were lower than low-risk HPV group and control group (P<0.05);expression of Sox-2 and Wnt/β-catenin signaling pathway protein Sox-2,β-catenin, wnt-1, wnt-3a in high-risk HPV group were higher than low-risk HPV group and control group (P<0.05).Conclusions:High-risk HPV infection can increase the expression of oncogenes and reduce the expression of anti-oncogenes in cervical dysplasia tissues on Sox-2- and Wnt/β-catenin signaling pathway manners.
文摘We submitted 437 patients with cytological alterations that suggest viral infections to HPV test. 154 patients (35.24%) resulted positive for HPV;among these, 128 (83.11%) with a low degree of infectivity, 19 (12.33%), with an average degree of infectivity and 7 (4.54%) with a high degree of infectivity).
基金The National Natural Science Foundation of China(81674011)。
文摘Objective:This study conducted a systematic review of randomized controlled trials in order to evaluate the efficacy and safety of Baofukang Suppository(保妇康栓)combined with interferon on cervical high-risk human papillomavirus(HR-HPV)infection.Methods:Data comes from China National Knowledge Infrastructure(CNKI),Wanfang database,the VIP information database,Chinese Biomedical Literature Database,PubMed,Cochrane Library,Web of Science and Embase.Primary and secondary outcome measures were extracted from 13 included randomized controlled trials:number of HR-HPV turning negative and effective,time of HPV turning negative,duration of abnormal vaginal secretions and adverse events.Results:Baofukang Suppository combined with interferon were better than interferon alone in improving the negative rate of HR-HPV(RR=1.42,95%CI[1.28,1.58],P<0.00001)and the effective rate of HR-HPV RR=1.3,95%CI[1.24,1.37],P<0.00001),time of HR-HPV turning negative(MD=-8.32,95%CI[-9.17,-7.47],P<0.00001),duration of abnormal vaginal secretions(MD=-8.95,95%CI[-11.34,-6.56],P<0.00001).However,there was no statistical difference in improving inflammatory factor(TNF-α:SMD=-0.49,95%CI[-1.02,0.03],Z=1.83,P=0.07;IL-6:SMD=-13.69,95%CI[-41.98,14.6],Z=0.95,P=0.34)and adverse events(RR=-0.73,95%CI[0.48,1.11,P=0.15)between two groups.Conclusion:The results showed that the efficacy of Baofukang Suppository combined with interferon were better than interferon alone in improving the negative and effective rate of HR-HPV,shortening the time of HR-HPV turning negative and duration of abnormal vaginal secretion and reducing adverse events.
文摘Objective:To study the relationship of high-risk human papilloma virus (HPV) infection with mitogen-activated protein kinase/extracellular signal-regulated kinase 3 (MEKK3) and nuclear factorκB (NF-κB) expression in cervical intraepithelial neoplasia tissue.Methods:125 cases of cervical biopsy specimens between May 2013 and March 2016 were collected. The cervical inflammation specimens, cervical intraepithelial neoplasia specimens and cervical cancer specimens were included in inflammation group, CIN group and malignant group respectively. HPV-DNA typing detection kits were used to determine HPV typing, immunohistochemical kits were used to determine MEKK3 and NF-κB protein expression, and fluorescent quantitative PCR kits were used to determine the mRNA expression of MEKK3, NF-κB and downstream molecules.Results: MEKK3 and NF-κB protein expression in high-risk HPV-positive cervical tissue were significantly higher than those in high-risk HPV-negative cervical tissue (P<0.05), and MEKK3, NF-κB, Bcl-2, XIAP, Bmi-1, TGF-β and Vimentin mRNA expression in high-risk type HPV-positive cervical tissue were significantly higher than those in high-risk HPV-negative cervical tissue (P<0.05);Bcl-2, XIAP, Bmi-1, TGF-β and Vimentin mRNA expression in tissue with positive MEKK3 and NF-κB expression were significantly higher than those in tissue with negative MEKK3 and NF-κB expression (P<0.05).Conclusions:High-risk HPV infection will increase the expression of proliferation genes Bcl-2, XIAP and Bmi-1 as well as invasion genes TGF-β and Vimentin in cervical intraepithelial neoplasia tissue through MEKK3/NF-κB pathway.
文摘Objectives: To identify the obstacles and issues that hinder effective cancer prevention efforts in Ukraine. The study aims to provide a comprehensive assessment of the barriers to cancer prevention, including both infrastructure and behavioral factors, and identify potential solutions to address these challenges. Study Design: Comprehensive literature review. Methods: The following databases were searched: National Center for Biotechnology Information (NCBI) and PubMed (U.S. National Library of Medicine at the National Institutes of Health). The keywords used in the search included “Cervical Cancer”, “Human Papillomavirus Vaccination (HPV)”, “Ukraine”, “Eastern Europe”, “Healthcare Infrastructure in Disasters”, “Cervical Cancer Prevention”, “Pap Smear”, and “HPV Testing”. Results: A total of 3500 articles were screened. A total of 65 articles met the inclusion criteria. Limited public awareness and limited access to vaccination and screening, combined with inadequate treatment facilities lead to higher rates of cervical cancer. The COVID pandemic, war with Russia, and the Chernobyl disaster are significant factors for the low level of vaccination in Ukraine. Conclusion: The prevention and treatment of cervical cancer in Ukraine face significant challenges due to the inadequate HPV vaccination rates and screening by cytology. Efforts to improve funding and increase education of both the population and health care providers are necessary to increase interventions such as HPV vaccination, cervical cytology, and HPV testing to reduce cervical cancer rates in Ukraine.
文摘Purpose: To understand the application of high-risk HPV detection combined with cervical cytology, colposcopy and pathology in cervical lesions of women in Tiandeng County. Method: Women in the outpatient and inpatient departments of our hospital from January 2021 to October 2022 were collected for high-risk HPV testing, TCT, colposcopy and pathological examination according to their personal wishes, to understand the application of relevant examinations in cervical lesions. Result: In 2021, the number of patients was 5801, among whom 1743 patients had received cervical cancer examination in the past, accounting for 30.05% of the total number of patients, and 5795 who had volunteered for TCT examination this time, accounting for 99.90% of the total;A total of 289 cases of atypical squamous cells with unclear significance (ASC-US) were detected, excluding 11 cases of high-grade squamous intraepithelial lesions (ASC-H), 122 cases of low-grade squamous intraepithelial lesions (LSIL), 16 cases of high-grade squamous intraepithelial lesions (HSIL), 2 cases of squamous cell carcinoma (SCC), and 4 cases of atypical adenocyte (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of people who volunteered for high-risk HPV testing was 4237, and the number of positive cases was 740, accounting for 17.47% of the screening population;Among 740 HPV-positive patients, 488 high-risk HPV-positive patients were selected for TCT examination, and 87 patients were found to be TCT positive;From 401 high-risk HPV-positive and TCT negative patients, 287 patients with possible lesions were screened out for colposcopy;The results showed that 60 patients may have certain cervical lesions and need further pathological examination and the results showed that 28 patients had CTN1 and 18 patients had CIN2 - 3. In 2022, 8840 patients received medical treatment, among which 3188 patients had received cervical cancer examination in the past, accounting for 36.06% of the total number of patients, and 8314 patients voluntarily underwent TCT examination, accounting for 94.05% of the total number of patients. 434 cases of atypical squamous cells with ambiguous meaning (ASC-US) were detected, excluding 13 cases of high-grade squamous intraepithelial lesions (ASC-H), 217 cases of low-grade squamous intraepithelial lesions (LSIL), 35 cases of high-grade squamous intraepithelial lesions (HSIL), 1 case of squamous cell carcinoma, and 4 cases of atypical adenocarcinoma (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of volunteers for high-risk HPV testing was 3871 cases, and the number of positive cases was 654 cases, accounting for 16.89% of the screening number. 527 high-risk HPV-positive patients were selected from 654 HPV-positive patients for TCT examination, and the number of TCT-positive patients was found to be 49. From 478 high-risk HPV-positive patients with TCT negative, 276 patients with possible lesions were screened out for colposcopy;The results showed that 66 patients may have certain cervical lesions and need further pathological examination;and then the results showed that 31 cases of CTN1 and 6 cases of CIN2 - 3. Conclusion: Gynecological high-risk HPV examination can provide better etiological sources for cervical cancer screening;Cervical cytology examination has high sensitivity;Colposcopy examination has high specificity;Pathological examination can be used as an effective supplement for cervical cytology examination and colposcopy;So high-risk HPV combined with cytology examination, colposcopy examination and pathological examination has high clinical application value;It is worth popularizing and applying.
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.
