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Objective To evaluate the risk of the occurrence of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer in the oral HPV carriers through a population-based investigation in Shanghai.Methods A total of 1200 cases of outpatients who attended the annual cervical examination and 50 preoperational cases of inpatients with CIN Ⅲ or invasive cervical cancer were enrolled from three clinical centers in Shanghai.The oral HPV infection was determined by real-time PCR.In 1200-case cross-sectional study,the incidence rate of CIN was compared between the oral HPV positive and negative cohort.In 1250-case case-control study,the positive rate of oral HPV DNA test was compared among normal control group,CIN Ⅰ-Ⅲ,and invasive cancer case groups,and all odds ratio (OR) values were calculated,respectively.The HPV transmission-related demographic and behavioral characters of the oral HPV carriers were also analyzed.Results The oral HPV carriers accounted for 5.9％ (71/1200) of the investigated outpatients.The oral HPV DNA positive rates were gradually increased with the cervical disease grades,which were 5.8％ (68/1182,normal),2/13 (CIN Ⅰ),1/5 (CIN Ⅱ),31.4％ (11/35,CIN Ⅲ) and 5/15 (invasive cancer).In cross-sectional cohort studies,the relative risks (RR) of CIN Ⅰ,Ⅱ were 2.9 and 4.0 for oral HPV carriers,respectively.In case-control study,the OR values for CIN Ⅰ-Ⅲ and invasive cervical cancer were 3.1(95％CI:1.6-10.1),4.2(95％CI:1.7-28.4),7.1(95％CI:4.8-19.8) and 10.1 (95％ CI:3.2-32.1),respectively.The oral sex and multi-sexual partner were two major risk factors for the oral and cervical HPV co-infection,HPV-related cervical cancer and precancerous diseases according to behavioral analysis.Conclusions There are complicated transmission pathways between oral and cervicalHPV.Oral HPV carriers should be intensively followed up and their oral HPV infection and HPV-related cervical diseases should be treated together.
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Background and purpose:The greastest diameter of cervical cancer with stage Ⅰ_(b2) disease was more than 4 cm in diameter. surgery as the fi rst priority was diffi cult in these patients, bleeding was the most frequent adverse effect. This article studied the effect of the cervical cancer with stage Ⅰ_(b2) disease underwent neoadjuvant chemotherapy with gemcitabin plus cisplatinum(DDP). Methods:23 cases (A groups) stage Ⅰ_(b2) cervical cancer were treated with gemcitabin 1.5 g/m2 iv infusion at d1, plus cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3. The interval between the two cycles was two weeks.19 cases (B groups) were treated with cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3,plus VCR 1.5 g/m2 iv infusion at d1, and BLM 10 mg/m2 im at d1-3, The interval between the two cycles was three weeks. The assessment for clinical effect and side effect were conducted for the patients with completion of at least two cycles of chemotherapy. Results:42 cases were enrolled in this trial. There was signifi cant(P=0.004) difference between the two groups with the shrinkage of the greatest diameter after neoadjuvant chemotherapy. The main toxicities were myelosuppression. There was signifi cant (P
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Purpose:To study the intraperitonal chemotherapy combined with intravenous chemotherapy after surgery for the treatment of ovarian cancer. Methods:The 88 patients of ovarian cancer after cytoreductive surgery were divided into two groups A and B. A group(45 cases) received intraperitonal chemotherapy three times once a week with DDP and 5-FU plus either the MMC or AT-1258, then intravenous chemotherapy, stages Ⅰ/Ⅱ 21 cases(23.86%),stages Ⅲ/Ⅳ 24 cases(27.27%). B groups were given intravenous chemotherapy with CAP protocol once every three weeks,stage Ⅰ/Ⅱ 24 cases(27.27%),stages Ⅲ/Ⅳ 19 cases(21.59%).Results:After three or six courses of chemotherapy there was significant decrease in CA125 both Ⅰ/Ⅱ and Ⅲ/Ⅳ in A and B groups . After three courses of chemotherapy there were 34 cases((38.64%))of A groups and 19 cases(21.59%)of the B groups with CA12535 u/ml(35 cases) who were given three courses of chemotherapy after entire treatment. A and B groups in the Ⅰ/Ⅱ stages showed average survival time (35.05?0.54),(32.38?1.19) months,and in the Ⅲ/Ⅳ stages showed average survival time (31.33?1.41),(28.26?1.88) months.There was no significance (P=0.156) with three year survival rate between A and B groups in the Ⅰ/Ⅱ stages with Log Rank test. There was no significance (P=0.08) in three-year survival rate between A and B groups in the Ⅲ/Ⅳ stages with Log Rank test. There was significance in three-year survival rate between A and B with intraperitonal fluid.Conclusions:The intraperitonal chemotherapy combined with intravenous chemotherapy after surgery for the treatment of ovarian cancer could marketly decrease CA125 than intravenous chemotherapy after three or six courses. Three-year survival ratewas significantly different between CA125 35 u/ml(35 cases) when they were given three courses of chemotherapy after entire treatment. Although the intraperitonal chemotherapy after surgery for the treatment of ovarian cancer had no significant difference between A and B groups in Ⅰ/Ⅱ and Ⅲ/Ⅳ stages with three-year survival rate , it appears longer survival time . There is significant difference with three-year survival between A and B with intraperitonal fluid. The intraperitional chemotherapy combined with intravenous chemotherapy after surgery can be used for the ovarian cancer with intraperitonal fluid and metastases.