Study on the Correlation between Human Papillomavirus and Mycoplasma genitalium Combined with TCT Detection

Objective: This study aims to explore the correlation between human papillomavirus (HPV) and Mycoplasma genitalium (CT) combined with TCT detection in cervical cancer screening. Method: A cross-sectional study design was adopted, and a total of 609 women who came to seek medical treatment were recruited as the study subjects. Combination testing was evaluated on cervical cancer screening by testing the women for HPV, CT with TCT detection and analyzing the relationship of cervical lesions with HPV and CT infection. Results: The study results showed that 21.57% of the subjects were infected with both HPV and CT, and 48.42% of the cases had abnormal TCT results at the same time. Further data analysis showed that HPV infection was significantly associated with abnormal TCT outcomes (p < 0.05), suggesting a possible synergistic effect of the two infections in cervical lesions. The combined sensitivity and specificity of HPV, CT and TCT detection were 21.57% and 48.42%, respectively, which were significantly higher than that of single detection. Conclusion: In summary, the results of this study support the importance of combined HPV, CT, and TCT testing in cervical cancer screening, and propose the hypothesis that combined testing may improve screening effectiveness. However, further large sample studies are needed to confirm this conclusion and explore the prospects of combined testing in clinical practice.

Evaluating the Association between Human Papillomavirus and Vulvar Cancer:A Comprehensive Analysis Using Bradford Hill Criteria

Background:The role of human papillomavirus(HPV)in the development of vulvar cancer(VC)has been widely studied,but findings have been inconsistent.Despite numerous meta-analyses exploring the potential link between HPV and VC,the association remains controversial due to inherent limitations in meta-analytic methods.Objectives:To address this controversy,the study aims to investigate the potential link between HPV and VC using the Bradford Hill criteria,which offer a more comprehensive framework for establishing causation.Methodology:The study began by extracting all relevant studies on the association between HPV and VC from the PubMed database.The potential links were then assessed by examining the data using the major postulates of the Bradford Hill criteria.To ensure the reliability of the findings,the methodologies of the identified studies were critically evaluated to account for possible false-negative and false-positive results.Results:The assessment of previous studies against the Bradford Hill criteria revealed that the major postulates were not fulfilled.Conclusion:Based on the findings,it can concluded that there is no causal association between HPV and VC.

HPV16 E6、E7多表位DNA疫苗的构建及免疫效果评估

目的构建和评价HPV16 E6、E7多表位DNA疫苗诱导的特异性CTL细胞应答及其对肿瘤生长的干预作用,从而揭示其作为候选HPV治疗性疫苗的潜能。方法首先通过IEDB网站中的MHC I Processing Predictions和MHC I Binding Predictions方法,分别预测人类HLA-A^(*)02:01、HLA-A^(*)11:01、HLA-A^(*)24:02和C57BL/6小鼠H-2b的限制性CTL表位,然后根据评分以及ELISPOT实验筛选出二者共同呈递的CTL表位,并将其构建成多表位DNA疫苗(pVAX1-10P)。从预防性和治疗性二个方面研究pVAX1-10P对小鼠移植TC-1异位癌的免疫干预作用,流式细胞术检测特异性CTL应答。结果获得10条可被人与鼠MHC分子共呈递的CTL表位,ELISPOT结果表明这10条CTL表位均能诱导小鼠淋巴细胞产生特异性免疫应答;由此构建的多表位DNA疫苗pVAX1-10P无论在预防性实验还是治疗性实验中,均能诱导特异性的细胞免疫并抑制肿瘤的生长。结论构建的HPV16 E6、E7多表位DNA疫苗pVAX1-10P能够诱导特异性CTL应答,显著抑制肿瘤生长,有望作为候选HPV治疗性DNA疫苗。

HPV-16 E6E7抗原表位嵌合体DNA疫苗黏膜免疫抑制宫颈癌的效果研究

目的 评价泛素及热休克蛋白70(HSP 70)C融合人乳头瘤病毒(HPV)16型E6E7表位嵌合体DNA疫苗鼻内黏膜免疫对宫颈癌移植瘤的预防和治疗效果。方法 建立TC-1小鼠肿瘤模型,以壳聚糖为发送载体,通过滴鼻免疫给药免疫C57BL/6小鼠。MTT法和淋巴毒性T细胞(CTL)反应检测小鼠脾脏T淋巴细胞增殖、流式细胞术检测细胞因子表达水平、肿瘤生长曲线和荷瘤小鼠存活时间评价壳聚糖包裹的HPV-16 E6E7嵌合体DNA疫苗鼻内黏膜免疫后对HPV-16型相关宫颈癌移植瘤的预防和治疗效果。结果 与对照组pcD-UH相比,实验组pcD-UE和pcD-UEH均具有显著的CTL反应,延缓HPV-16型相关宫颈癌移植瘤生长,但对已生成肿瘤无影响。鼻内黏膜途径发送壳聚糖包裹HPV-16 E6E7抗原表位嵌合体DNA疫苗仅能产生较弱的细胞免疫应答。结论 HPV-16 E6E7抗原表位嵌合体DNA疫苗通过鼻腔免疫,具有一定的肿瘤治疗和显著的肿瘤预防效果,为新型HPV疫苗的研制奠定了基础。

HPV16 E6调控miR-23a表达促进宫颈癌细胞侵袭、迁移

目的探讨高危型人乳头瘤病毒16 E6蛋白(HPV16 E6蛋白)调控miR-23a表达对宫颈癌细胞SiHa侵袭、迁移的作用。方法选取100例宫颈癌HPV阴性患者、100例HPV阳性患者的组织标本、100例癌旁正常组织;宫颈癌SiHa细胞分为空白组、E6过表达组、阴性转染组、E6+miR-23a mimics组;qRTPCR法检测miR-23a、HPV16 E6 mRNA表达;MTT法检测增殖抑制率;流式细胞仪检测凋亡;Transwell小室实验检测细胞侵袭;划痕实验检测细胞迁移;WB检测HPV16 E6、凋亡相关蛋白(Caspase-3、Bax、Bcl-2)、迁移相关蛋白(MMP-2、MMP-9)的表达。结果宫颈癌组织中miR-23a表达降低,其中宫颈癌HPV阳性组织中miR-23a表达水平更低。E6过表达降低miR-23a表达水平、细胞增殖抑制率、凋亡率、Caspase-3、Bax蛋白表达,增高Bcl-2蛋白、划痕愈合率、侵袭细胞数、MMP-2、MMP-9蛋白表达(P<0.05);miR-23a mimics逆转了E6过表达对上述各项指标的影响。结论HPV16 E6促进宫颈癌细胞侵袭、迁移可能与调控miR-23a表达有关。

STAT3的多态性在HPV16所致宫颈癌发生中的作用

目的:研究人乳头状瘤病毒16(HPV16)所致宫颈癌发生过程中转录活化子3(STAT3)多态性的作用。方法:回顾性选取2019年至2023年入院的34例宫颈癌患者为观察对象,将其设为A组,选取同一时期入院的54例宫颈上皮内瘤变患者将其设为B组,同时选取同一时期入院的80例慢性宫颈炎患者将其设为C组。HPV16 E6蛋白测定方式主要为免疫组化、聚合酶链反应(PCR)-反向点杂交法,STAT3测定方式主要为PCR法,STAT3基因C1697G多态性测定方式主要为PCR-制片段长度多态性(RFLP),比较并分析三组患者E6蛋白、STAT3蛋白阳性表达率与STAT3基因多态性表达情况。结果:与B、C组相比,A组患者E6、STAT3蛋白阳性表达率明显更高,差异有统计学意义(P<0.0167);相比C组患者,B组患者E6蛋白、STAT3蛋白阳性表达率明显更高,差异有统计学意义(P<0.0167)。相比C组患者,A、B组患者G/G型构成比明显更低,C/C型构成比明显更高,差异有统计学意义(P<0.0167);相比B组患者,A组患者G/G型构成比明显更低,C/C型构成比明显更高,差异有统计学意义(P<0.0167);三组患者G/C型构成比差异无统计学意义(P>0.0167)。结论:HPV16所致宫颈癌发生及发展过程中STAT3及其多态性可能有重要作用。

高迁移率族蛋白B1巨噬细胞转移抑制因子联合CXC亚家族趋化因子16对高危型HPV感染患者诊断价值

目的:探究高迁移率族蛋白B1(HMGB1)、巨噬细胞转移抑制因子(MIF)联合CXC亚家族趋化因子16(CXCL16)在高危型人乳头状瘤病毒(HPV)感染患者中的表达意义及诊断价值。方法:纳入本院2020年10月至2023年10月期间接诊的150例HPV感染患者作为研究组,根据患者核酸检测结果分为高危型HPV感染组(n=40)和低危型HPV感染(n=110)。另选取同期于本院接受经阴道镜活检检查的健康女性作为对照组(n=100)。对研究组患者均采用HPV-DNA分型试剂盒检测;对研究组和对照组人员采用酶联免疫吸附法检测HMGB1和CXCL16水平,免疫组化检测MIF染色强度。对比对照组和研究组HMGB1、MIF和CXCL16差异;对比低危型和高危型HPV感染组HMGB1、MIF和CXCL16差异;采用受试者特征曲线(ROC)分析HMGB1、MIF和CXCL16联合检测对高危型HPV感染诊断价值;Spearman相关性分析HMGB1、MIF和CXCL16与不同HPV感染分型相关性。结果:与对照组相比,研究组血清HMGB1、CXCL16水平和MIF阳性细胞占比得分显著更高(均P<0.05);与低危型HPV感染组相比,高危型HPV感染组血清HMGB1、CXCL16水平和MIF阳性细胞占比得分显著更高(均P<0.05);ROC工作曲线分析结果显示HMGB1、MIF和CXCL16单独及联合诊断高危型HPV感染的AUC分别为0.748、0.684、0.791和0.934,联合检测诊断价值显著高于单独检测(Z=2.577、3.152、2.096,均P<0.05);Spearman相关性结果显示HMGB1、MIF和CXCL16与不同HPV感染分型存在显著正相关(r=0.615、0.633、0.649均P<0.05)。结论:高危型HPV感染患者血清HMGB1、CXCL16水平和MIF阳性细胞占比得分显著高于低危型和对照组,临床检查中应用HMGB1、MIF和CXCL16联合检测可提升高危型HPV感染临床诊断率,为临床提供一种新型检测方法和治疗依据。

Distribution of High-Risk Human Papillomavirus Genotypes among Women with Colposcopic Diagnosis of Cervical Intraepithelial Neoplasia in Bangladesh

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.

Safety and immunogenicity of human papillomavirus-16/18 AS04-adjuvanted vaccine in healthy Chinese females aged 15 to 45 years:a phase Ⅰ trial

Globally,about 70% of cervical cancers are associated with human papillomavirus (HPV)-16 or HPV-18 infection.A meta-analysis of epidemiologic studies in China showed that HPV was present in 98% of cervical cancer samples.The HPV-16/18 AS04-adjuvanted vaccine Cervarix has shown a high level of protection against HPV-16/18 infections and associated cervical lesions.This phase Ⅰ trial (NCT00549900) assessed the safety,tolerability,and immunogenicity of the vaccine in Chinese.Thirty healthy Chinese females,aged 15 to 45 years with a median age of 29.5 years,received three doses of Cervarix in Months 0,1,and 6.Safety was assessed via recording solicited local and systemic symptoms within 7 days and unsolicited symptoms within 30 days after each vaccination.Serious adverse events,new onset of chronic diseases,and other medically significant conditions were recorded throughout this trial.As an exploratory objective,HPV-16/18 antibody titers were determined by enzyme-linked immunosorbent assay in serum samples collected in Months 0 and 7.Pain at the injection site was the most frequently reported local symptom.Two subjects reported medically significant adverse events.Both cases were assessed as unrelated to vaccination by the investigator.In Month 7,100% seroconversion was observed for both anti-HPV-16 and anti-HPV-18 with high geometric mean antibody titers.HPV-16/18 AS04-adjuvanted vaccine,evaluated for the first time in Chinese females,was generally well tolerated and immunogenic,as previously shown in global studies.

Apoptosis of HeLa cells inhibited by human papillomavirus type 16 E6 protein interacting with hDaxx

Objective: To study the interaction of human papillomavirus type 16 (HPV16 E6) protein and human death domain associated protein (hDaxx) and its effect on apoptosis of HeLa cells to provide the experimental basis for exploring the oncogenic mechanism of HPV16 E6 protein. Methods: Recombinant vector of pGADT7/E6 or pGBKT7/hDaxx was con- structed. The interaction of E6 protein and hDaxx was detected by yeast two-hybrid system. Their expression in yeast was detected by Western blotting. The eukaryotic plasmids of E6 and hDaxx were co-transfected into HeLa cells. Apoptosis was induced by 5-FU. The apoptotic rate was measured by flow cytometry (FCM). Results: E6 protein had intracellular interaction with hDaxx. The apoptotic rate was rising with the increase in the transfection quantity of pcDNA3.1 (-) / hDaxx in pcDNA3.1 (-) /E6 and pcDNA3.1 (-) / hDaxx co-transfected cells. The difference was significant ( P < 0. 01). Conclusion: There is intracellular interaction between HPV16 E6 protein and hDaxx. The over-expression of hDaxx can increase the sensitivity of E6 protein positive HeLa cells to 5-FU. The effect was in a dose dependent manner. HPV16 E6 protein inhibited the apoptosis of HeLa cells by interacting with hDaxx.

PRELIMINARY STUDY OF A NOVEL HUMAN PAPILLOMAVIRUS TYPE 16 L1/E6-E7 CHIMERIC RECOMBINANT DNA VACCINE

Objective Preparations of HPV16 L1/E6 and L1/E7 prophylactic and therapeutic DNA vaccines. Methods The nucleotides within HPV16 E6 and E7 genes, which are responsible for viral transforming activity, were mutated by mage primer site-directed mutagenesis method. The correctly mutated E6 and E7 fragments were separately cloned into an eukaryotic expression vector pVAX1, together with HPV16 L1 gene, generating chimeric recombinants plasmids 1MpVAX1-L1E6, 2MpVAX1-L1E6, 1MpVAX1-L1E7, 2MpVAX1-L1E7 and 3MpVAX1-L1E7. CHO cells were transiently transfected with the individual DNA vaccines by calcium phosphate method. Target protein expressions in the extracts of the transfected cell lines were measured by ELISA and immunohistochemistry, with HPV16 L1 and E6 specific monoclonal antibodies. Results ELISA assays showed the P/N ratios in the cell extracts transfected with L1E6 and L1E7 plasmids were more than 2.1. Immunohistochemistry revealed brownish precipitant signal in cytoplasm and nuclei of the transfected cells. Conclusion Successful constructions of prophylactic and therapeutic DNA vaccine plasmids lay solid foundation for future animal experiment and clinical trial.

SEARCH FOR HERPES SIMPLEX VIRUS TYPE2（HSV－2）AND HUMAN PAPILLOMAVIRUS（HPV）IN THE NORMAL AND ABNORMAL CERVICAL SAMPLES

The specimens of 111 cervical carcinomas. 68 chronic cervicitis and 43 normal cervical exfoliated epithelial cells were examined for the presence of HSV2 DNA sequences with DNA hybridization using HSV2 BgL Ⅱ N fragment probe labelled by 32PdCTP. The result showed that the infection rates of HSV2 in the samples of cervical cancer.chronic cervicitis and normal epithelial cells were 1 4. 41 %(16/111). 27.94%( 19/68) and 25.58% ( 11/43),respectively. It was implied that early stages carcinogenesis of cervical epithelial cells might be correlated with the HSV2 infection.Sixteen HSV 2 positive samples of cervical carcinomas were also examined for the presence of the sequences homologous to human papillomavirus (HPV) type 6B/11. 16 and 18 DNA using dot blot hybridization (Tm17℃). The result indicated that 13 out of 16 were HPV 16 DNA hybridization positive accounting for 81. 2% of all HSV-2 positive samples and none of them were positive for HPV type 6B/11 and 18. The result indicated that double infection of HSV 2 and HPV16 in the same cervical carcinoma tissues may provide a strong evidence of the viral synergistic interaction in the induction of female cervical

Detection of Human Papillomavirus Type 16 DNA in Cervical Carcinomas

Accurate typing of the different human papillomavirus types is csscntial in view of the differ-ent pathological potential of the common virus types of human papillomavirus （HPV） present in thecervix. We have developed hybridization, washing and autoradiography conditions that minimize thecross-hybridization among different specific types of HPV so as to allow clear - cut type assignmentthrough practical dot blot hybridization technique using nylon membrane and 35S - labeled HPV - 16DNA probe. Under these conditions seventeen of thirty （56.7%） of squamous cell carcinomas of thecervix uteri obtained from Tianjin women were detected in the presence of HPV - 16 DNA.

Transient over-expression of human papillomavirus type 16 E6 protein down-regulate the secretion of TNF-αor IL-1β LPS-induced from macrophages

In order to provide the experimental basis for the further studies on the oncogenic mechanism of the E6 protein from human papillomavirus type 16 （HPV16）, the eukaryotic expression vector pcDNA3.1 （-）/E6 was used for the study on the effect of E6 protein to influence the secretory activity of LPS-induced 3MP-1-macrophages, and the reconstructed plasmid pcDNA3.1 （-）/E6 was transfected into THP-1-macrophages. The expression of E6 gene was assayed in macrophage lysates by using Western blot analysis and the level of TNF-α or IL-1β was examined by ELISA. All of data were analyzed by SPSS12.0. As demonstrated by Western blot analysis, the expression of E6 protein with a molecular weight of about 18 kDa by plasmid pcDNA3.1 （-）/E6 in THP-1-macrophages could be detected. However, as demonstrated by ELISA assay, the level of TNF-α or IL-1β in lysates of THP-1-macrophages showed an obvious difference between the pcDNA3.1 （-）/E6 group and the LPS control group or the pcDNA3.1 （-） control group （P 〈 0.01）, but no significant difference existed between pcDNA3.1 （-） control group and LPS control group （ P 〉 0.05）. All these results illustrate that the transient over-expression of HPV6 E6 protein reduces the production of TNF-α and IL-1β induced by LPS in THP-1-macrophages.

血清HMGA1、CXCL16水平与宫颈癌患者HPV感染分型的相关性分析

目的探究血清高迁移率族蛋白A1(HMGA1)、CXC亚家族趋化因子16(CXCL16)水平与宫颈癌患者人乳头瘤病毒(HPV)感染分型的相关性。方法回顾性选取2020年7月至2021年7月来广西医科大学附属第二医院妇科就诊的宫颈癌患者91例作为研究对象,检测所有患者的HPV感染分型情况。根据检查结果,45例患者(HPV感染基因型为HPV16、18、31、33、35、39、45、51、52、56、58、59、66、68等高危HPV分型)为高危组,46例患者(HPV感染分型为HPV6、11、42、43、44等)作为低危组,另选同期来广西医科大学附属第二医院进行体检的健康志愿者50名作为对照组。采用微粒子酶免疫分析法检测3组血清HMGA1水平进行,酶联免疫吸附试验检测3组血清CXCL16水平;采用Logistic回归分析分析血清HMGA1、CXCL16水平与宫颈癌患者HPV感染分型(高危型和低危组)的相关程度。结果高危组患者血清HMGA1、CXCL16水平分别为(156.23±16.14)ng/mL、(10.45±3.12)pmol/L,低危组血清HMGA1、CXCL16水平分别为(122.54±17.78)ng/mL、(4.45±1.32)pmol/L,均显著高于对照组[(106.32±15.54)ng/mL、(2.45±0.03)pmol/L],且高危组均明显高于低危组,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,血清HMGA1、CXCL16水平与宫颈癌患者HPV感染分型具有相关性(OR=1.104,95%CI:1.028~1.186;OR=2.911,95%CI:1.605~5.278;P<0.05)。结论宫颈癌患者血清HMGA1、CXCL16水平呈高表达,且高危组患者的血清HMGA1、CXCL16水平较低危组升高明显,血清HMGA1、CXCL16水平与宫颈癌患者HPV感染分型具有一定相关性。

新疆地区食管鳞状细胞癌患者HPV16/18感染与其临床病理特征及预后的关系

目的探讨新疆地区食管鳞状细胞癌(ESCC)患者人乳头瘤病毒(HPV)16/18感染与其临床病理特征及预后的关系。方法选取ESCC患者110例,均行根治性手术治疗,术中取ESCC组织。用原位杂交技术检测ESCC组织中HPV16/18阳性表达,HPV16或HPV18检测阳性可判定为HPV16/18感染。对患者进行随访,统计资料完整91例患者的3年生存情况,用Kaplan-Meier法和Cox比例风险模型进行生存分析。结果在30%(33/110)的ESCC组织中观察到呈棕褐色的HPV16/18阳性颗粒,其主要定位于细胞核内。HPV16/18感染与ESCC浸润深度、淋巴结转移、病理分期、脉管侵犯有关(P均<0.05),与性别、年龄及分化程度无关(P均>0.05)。91例患者中HPV16/18阴性61例、HPV16/18阳性30例。HPV16/18阳性患者生存期短于阴性患者,3年生存率低于阴性患者,比较差异均有统计学意义(P均<0.05)。HPV16/18阳性、有淋巴结转移、分化程度低、有脉管侵犯是ESCC患者预后不良的独立危险因素(P均<0.05)。结论HPV16/18感染可能与ESCC的发生发展有关,且提示患者预后不良。

基于ARIMA模型的天津地区单中心HPV感染趋势及基因型特征

目的采用自回归移动平均(ARIMA)模型构建时间序列,分析天津地区单中心人乳头瘤病毒(HPV)感染趋势及基因型特征。方法选择2018年1月-2022年12月某院进行HPV检测的7236例女性患者,比较2018-2022年天津地区HPV感染情况及基因型分布。建立ARIMA模型时间序列,分析模型拟合。预测2023年HPV感染数,并与实际发生数进行比较,评价模型的预测效果。结果2018-2022年天津地区HPV感染率为14.41%;HPV感染率在31~40岁年龄段最高,感染率为15.47%。阳性标本中HPV单一型别感染比率最高,占比为73.54%(767/1043),以高危型HPV为主。低危型感染占比最高的是HPV-6型,为2.59%,高危型感染占比最高的是HPV-16型,为16.06%。建立ARIMA模型,确定最佳模型为ARIMA(0,1,2)(0,1,1)12,其AIC值和BIC值分别为3.877、4.005,经白噪声检验Ljung-Box Q=8.828差异无统计学意义(P>0.05)。利用模型预测2023年HPV感染数,实际值、预测值的总体趋势基本保持一致,模型RMSE、MAPE、MAE分别为6.289、34.149、4.706,提示模型的预测效果较好。结论天津地区女性人群中,HPV病毒感染类型以单一高危型感染为主,其中HPV-16型感染率最高。天津地区HPV感染存在季节性,ARIMA模型在HPV感染流行趋势的预测中效果较好,适用于短期预测。

Reid阴道镜评分、HPV E6/E7 mRNA表达量在宫颈癌中的临床应用价值研究

目的研究Reid阴道镜评分(以下简称Reid评分)、高危型人乳头瘤病毒(HR-HPV)mRNA表达量与宫颈癌国际妇产科联盟(FIGO)分期、血清常规肿瘤标志物水平的相关性及对宫颈癌术后淋巴结转移的预测价值。方法选取2021年3月至2022年5月在菏泽市立医院就诊的100例宫颈癌患者作为宫颈癌组,另选同期诊治的50例低级别鳞状上皮内病变(LSIL)患者作为LSIL组,50例高级别鳞状上皮内病变(HSIL)患者作为HSIL组。比较3组Reid评分、HPV E6/E7 mRNA表达量及血清常规肿瘤标志物[糖类抗原125(CA125)、癌胚抗原(CEA)]水平;分析宫颈癌组Reid评分、HPV E6/E7 mRNA表达量与血清常规肿瘤标志物水平及宫颈癌FIGO分期的相关性;根据宫颈癌组患者术后随访结果分为术后有淋巴结转移和无淋巴结转移,比较有无淋巴结转移患者Reid评分、HPV E6/E7 mRNA表达量及血清CA125、CEA水平,分析Reid评分、HPV E6/E7 mRNA表达量对宫颈癌术后淋巴结转移的预测价值。结果宫颈癌组Reid评分、HPV E6/E7 mRNA表达量及血清CA125、CEA水平均高于HSIL组、LSIL组(P<0.05);HSIL组Reid评分、HPV E6/E7 mRNA表达量及血清CA125、CEA水平均高于LSIL组(P<0.05)。宫颈癌患者Reid评分、HPV E6/E7 mRNA表达量与血清CA125、CEA水平均呈正相关(r=0.405~0.705,P<0.05)。Reid评分、HPV E6/E7 mRNA表达量与宫颈癌FIGO分期呈正相关(r=0.415、0.501,P<0.05)。宫颈癌组术后淋巴结转移患者的Reid评分、HPV E6/E7 mRNA表达量及血清CA125、CEA水平均高于无淋巴结转移的患者(P<0.001)。Reid评分、HPV E6/E7 mRNA表达量、CA125、CEA预测宫颈癌术后淋巴结转移的曲线下面积(AUC)分别为0.756(95%CI:0.657~0.838)、0.760(95%CI:0.662~0.841)、0.803(95%CI:0.710~0.877)、0.768(95%CI:0.670~0.848)。将CA125、CEA联合检测作为常规预测方案,Reid评分、HPV E6/E7 mRNA表达量、CA125、CEA联合检测作为新预测方案,常规预测方案预测宫颈癌术后淋巴结转移的曲线下面积(AUC)为0.826(95%CI:0.724~0.889),新预测方案预测宫颈癌术后淋巴结转移的AUC为0.955(95%CI:0.892~0.987),新预测方案预测的AUC明显大于常规预测方案(Z=1.981,P=0.045)。与常规预测方案比较,新预测方案的净重新分类指数为0.021(95%CI:0.015~0.039)、综合判别改善指数为0.046(95%CI:0.033~0.069),均P<0.05。结论Reid评分、HPV E6/E7 mRNA表达量与宫颈癌FIGO分期及血清CEA、CA125水平相关,且在预测宫颈癌术后淋巴结转移方面具有一定价值。

北京某三甲医院健康体检女性HPV感染情况及TCT结果分析

目的探讨北京某三甲医院健康体检女性HPV感染情况及TCT结果分析,为本地区宫颈癌防治提供参考。方法回顾分析2022年7月至2023年9月于中日友好医院进行健康体检的10124例女性HPV及TCT结果。结果健康体检女性10124例中,HPV阳性率为7.34%,不同年龄段间HPV阳性率比较差异具有统计学意义(χ^(2)=29.721,P<0.001)。高危型HPV占比前五位亚型是HPV⁃52、HPV⁃58、HPV⁃51、HPV⁃16和HPV⁃39。TCT结果阳性率为2.49%,≥61岁人群ASC和HSIL占比最高,21~岁人群LSIL组占比最高。随着宫颈病变加重,从ASC到LSIL再到HSIL,HPV的阳性率逐渐升高(51.41%,70.18%,88.89%),不同程度宫颈病变的HPV阳性率比较差异具有统计学意义(χ^(2)=485.453,P<0.001),不同程度宫颈病变之间HPV感染类型比较差异有统计学意义(χ^(2)=18.943,P<0.001)。结论宫颈病变程度加重,HPV感染率升高,应重视本地区适龄妇女宫颈癌筛查。

亚洲人群HPV疫苗免疫原性及安全性的Meta分析

目的评估人乳头状瘤病毒(HPV)疫苗在亚洲人群中接种后的免疫原性和安全性。方法本研究分别检索英文数据库(PubMed、Embase、Web of Science、Clinical Trails、Cochrane library)和中文数据库(中国知网、万方、维普),自建库至2022年4月,关于亚洲人群进行的HPV疫苗安全性和免疫原性临床试验文献。采用主题词与自由词灵活搭配检索并结合纳排标准筛选文献,对最终纳入文献进行质量评价并提取资料,应用Meta分析合并评估。结果最终纳入16篇随机对照试验(RCT)研究,累计研究对象25485人。Meta分析表明对于HPV疫苗免疫原性,HPV16型特异性血清转化率合并效应值RR为43.74(16.51~115.85),HPV18型特异性血清转化率合并效应值RR为45.72(8.78~238.13)。对于HPV疫苗安全性,二价与四价HPV疫苗接种局部不良事件风险试验组高于对照组,RR为1.52(1.34~1.73)和1.38(1.20~1.59)。二价HPV疫苗与四价HPV疫苗试验组发生全身性不良事件的风险也高于对照组,RR分别为1.21(1.11~1.32)和1.13(0.99~1.30)。结论接种亚洲人群HPV疫苗后血清抗体阳转率高于未接种者,提示接种HPV疫苗可以提高个体特异性抗体水平,接种HPV疫苗发生局部和全身性安全事件的风险均高于对照组,提示仍要高度重视HPV疫苗的安全性问题。