Collagen provides tissue strength and structural integrity.Quanti fication of the orientated dispersion of collagen fibers is an important factor when studying the mechanical properties of the cervix.In this study,for...Collagen provides tissue strength and structural integrity.Quanti fication of the orientated dispersion of collagen fibers is an important factor when studying the mechanical properties of the cervix.In this study,for the first time,a new method for rapid characterization of the collagen fiber orientations of the cervix using linearly polarized light colposcopy is presented.A total of 24 colposcopic images were captured using a cross-polarized imaging system with white LED light sources.In the preprocessing stage,the Red channel of the RGB image was chosen,which contains no information of the blood vessels because of the low-absorption of blood cells in the red region.OrientationJ,which is an ImageJ plug-in,was used to estimate the local orientation of the collagen fibers.The result shows that in the nonpregnant cervix,the middle zone(Zone 2)has circumferentially aligned collagen fibers while the inner zone(Zone 1)has randomly arranged.The collagen fiber dispersion in Zone 2 is much smaller than that in Zone 1 at all four quadrants region(anterior,posterior,left,and right quadrant).This new analysis technique could potentially combine with diagnostic tools to provide a quantitative platform of collagen fibers in the clinic.展开更多
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
基金supported by the Ho Chi Minh City Department of Science and Technology of Vietnam,under grant number 116/2020/HDQPTKHCN.
文摘Collagen provides tissue strength and structural integrity.Quanti fication of the orientated dispersion of collagen fibers is an important factor when studying the mechanical properties of the cervix.In this study,for the first time,a new method for rapid characterization of the collagen fiber orientations of the cervix using linearly polarized light colposcopy is presented.A total of 24 colposcopic images were captured using a cross-polarized imaging system with white LED light sources.In the preprocessing stage,the Red channel of the RGB image was chosen,which contains no information of the blood vessels because of the low-absorption of blood cells in the red region.OrientationJ,which is an ImageJ plug-in,was used to estimate the local orientation of the collagen fibers.The result shows that in the nonpregnant cervix,the middle zone(Zone 2)has circumferentially aligned collagen fibers while the inner zone(Zone 1)has randomly arranged.The collagen fiber dispersion in Zone 2 is much smaller than that in Zone 1 at all four quadrants region(anterior,posterior,left,and right quadrant).This new analysis technique could potentially combine with diagnostic tools to provide a quantitative platform of collagen fibers in the clinic.
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.
