Numerous cellular and molecular events have been described in development of gastric cancer. In this artide, we overviewed roles of Helicobacter pylori （H pylori） infection on some of the important events in gastric...Numerous cellular and molecular events have been described in development of gastric cancer. In this artide, we overviewed roles of Helicobacter pylori （H pylori） infection on some of the important events in gastric carcinogenesis and discussed whether these cellular and molecular events are reversible after cure of the infection. There are several bacterial components affecting gastric epithelial kinetics and promotion of gastric carcinogenesis. The bacterium also increases risks of genetic instability and mutations due to NO and other reactive oxygen species. Epigenetic silencing of tumor suppressor genes such as RUNX3 may alter the frequency of phenotype change of gastric glands to those with intestinal metaplasia. Host factors such as increased expression of growth factors, cytokines and COX-2 have been also reported in non-cancerous tissue in Hpylori-positive subjects. It is noteworthy that most of the above phenomena are reversed after the cure of the infection. However, some of them including overexpression of COX-2 continue to exist and may increase risks for carcinogenesis in metaplastic or dysplastic mucosa even after successful H pylori eradication. Thus, H pylori eradication may not completely abolish the risk for gastric carcinogenesis. Efficiency of the cure of the infection in suppressing gastric cancer depends on the timing and the target population, and warrant further investigation.展开更多
Background For cervical cancer screening,routine cytology has a high specificity but a lower sensitivity.In older women,atrophy,which may mimic HSIL,presents a diagnostic challenge.p16 is a widely used biomarker for h...Background For cervical cancer screening,routine cytology has a high specificity but a lower sensitivity.In older women,atrophy,which may mimic HSIL,presents a diagnostic challenge.p16 is a widely used biomarker for histological diagnosis of HSIL.Our objective was to evaluate PathCIN®p16INK4a immunocytology in identification of high grade dysplasia vs.benign atrophy.Methods As part of a multi-center screening program,3351 women were co-tested by p16 immunocytology.Among women referred for colposcopy on basis of cytology and high-risk HPV status,those with atrophy were older than the population screened(52 vs.43 years).Cases from older women with atrophy(n=116)and controls without atrophy(n=47)were identified by re-examination of Pap smears.The detection of CIN2+was compared for p16,cytology and HR-HPV results.Results The sensitivity of routine cytology(≥LSIL)was much lower for cases with atrophy(17%)than non-atrophic cases(75%).The sensitivity of p16 immunocytology and of HR-HPV testing was high(88%–100%)both with and without atrophy.The specificity of routine cytology(≥LSIL)was higher for cases with atrophy(79%)than non-atrophic cases(38%).The specificity of p16 immunocytology was high(88–95%)and the specificity of HR-HPV testing was low(31%–33%)both with and without atrophy.Combining p16 with HPV testing and/or routine cytology had no benefit,as compared to p16 staining alone.Conclusions p16 immunocytology compares favorably with routine cytology and HPV testing in the differential diagnosis of HSIL and benign atrophy.It is more sensitive than cytology for atrophic specimens,and is more specific than HPV testing.p16 immunocytology may decrease the need for colposcopy referrals and could be a useful tool for early detection of cervical cancer in peri-and post-menopausal women,who are more likely to have HSIL coexisting with atrophy.展开更多
文摘Numerous cellular and molecular events have been described in development of gastric cancer. In this artide, we overviewed roles of Helicobacter pylori （H pylori） infection on some of the important events in gastric carcinogenesis and discussed whether these cellular and molecular events are reversible after cure of the infection. There are several bacterial components affecting gastric epithelial kinetics and promotion of gastric carcinogenesis. The bacterium also increases risks of genetic instability and mutations due to NO and other reactive oxygen species. Epigenetic silencing of tumor suppressor genes such as RUNX3 may alter the frequency of phenotype change of gastric glands to those with intestinal metaplasia. Host factors such as increased expression of growth factors, cytokines and COX-2 have been also reported in non-cancerous tissue in Hpylori-positive subjects. It is noteworthy that most of the above phenomena are reversed after the cure of the infection. However, some of them including overexpression of COX-2 continue to exist and may increase risks for carcinogenesis in metaplastic or dysplastic mucosa even after successful H pylori eradication. Thus, H pylori eradication may not completely abolish the risk for gastric carcinogenesis. Efficiency of the cure of the infection in suppressing gastric cancer depends on the timing and the target population, and warrant further investigation.
基金supported by grants from Shenzhen Technical Research and Development on Gynecologic Diseases(GCZX2015043016200372)Shenzhen Sanming Project(SZSM202011016)+1 种基金Shenzhen Key Medical Discipline Construction Fund(SZXK027)Shenzhen High-level Hospital Construction Fund(YBH2019-260).
文摘Background For cervical cancer screening,routine cytology has a high specificity but a lower sensitivity.In older women,atrophy,which may mimic HSIL,presents a diagnostic challenge.p16 is a widely used biomarker for histological diagnosis of HSIL.Our objective was to evaluate PathCIN®p16INK4a immunocytology in identification of high grade dysplasia vs.benign atrophy.Methods As part of a multi-center screening program,3351 women were co-tested by p16 immunocytology.Among women referred for colposcopy on basis of cytology and high-risk HPV status,those with atrophy were older than the population screened(52 vs.43 years).Cases from older women with atrophy(n=116)and controls without atrophy(n=47)were identified by re-examination of Pap smears.The detection of CIN2+was compared for p16,cytology and HR-HPV results.Results The sensitivity of routine cytology(≥LSIL)was much lower for cases with atrophy(17%)than non-atrophic cases(75%).The sensitivity of p16 immunocytology and of HR-HPV testing was high(88%–100%)both with and without atrophy.The specificity of routine cytology(≥LSIL)was higher for cases with atrophy(79%)than non-atrophic cases(38%).The specificity of p16 immunocytology was high(88–95%)and the specificity of HR-HPV testing was low(31%–33%)both with and without atrophy.Combining p16 with HPV testing and/or routine cytology had no benefit,as compared to p16 staining alone.Conclusions p16 immunocytology compares favorably with routine cytology and HPV testing in the differential diagnosis of HSIL and benign atrophy.It is more sensitive than cytology for atrophic specimens,and is more specific than HPV testing.p16 immunocytology may decrease the need for colposcopy referrals and could be a useful tool for early detection of cervical cancer in peri-and post-menopausal women,who are more likely to have HSIL coexisting with atrophy.
