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Objective: To identify appropriate ways of applying the current cervical screening methods to minimize the occurrence of missed diagnosis of high-grade cervical intraepithelial neoplasia (CIN2/3) and cervical cancer. Methods: A retrospective analysis was conducted based on the clinical data of 318 patients, who had CIN2/3 or cervical cancer and were treated in Aviation General Hospital Affiliated to China Medical University between June 2014 and August 2018. Among these cases, 296 involved CIN2/3, and 22 involved cervical cancer. All of the patients involved underwent a thinprep cytology test (TCT) and high-risk human papilloma virus (hrHPV) screening, and their age and TCT and hrHPV results were further analyzed. Results: Among the 296 patients diagnosed with CIN2/3, 130 of them (43.92%) were aged between 30 and 39 years, ranking the top among all age groups. Sixty-nine young patients (23.31%) aged between 20 and 29 years were diagnosed with CIN2/3, ranking in the third place. Among all of the 318 cases, the TCT results were positive in 199 cases (62.58%), hrHPV results were positive in 308 cases (96.86%), and there were 313 cases (98.43%, 313/318) wherein both TCT and hrHPV results were positive according to joint screening. The most predominant hrHPV subtypes were 16, 52, 58, 33, 18, and 31. Conclusions: As an increasing number of young women are diagnosed with CIN2/3 and cervical cancer, their screening should not be ignored. Single use of TCT screening leads to more frequent missed diagnosis of high-grade lesions compared with single use of hrHPV screening, while joint use of both screening methods could improve the detection rate. Even if TCT results were negative, it is suggested to conduct a colposcopy for those patients with high-risk subtypes besides hrHPV16 and 18 positivity, and in particular, for patients with hrHPV 52,58,33, and 31 positivity.
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Objective To explore the clinical value of examining HPV E6/E7 mRNA level in assessing cervical le?sions infected with high-risk human papillomavirus (HR-HPV). Methods The cervical epithelial cells were collected from 265 patients with HR-HPV infection, including 100 cases of neoplasia free/inflammation group (control group), 88 cas?es of cervical intraepithelial neoplasia (CIN)Ⅰ, 33 cases of CINⅡ, 28 cases of CINⅢand 16 cases of cervical carcinoma and the transcription of HPV E6/E7 mRNA level was examined using branched DNA (b-DNA) technology. Results The positive rate HPV E6/E7 mRNA were higher in CIN Ⅱ(81.82%), CINⅢ(89.29%) and cervical cancer group (100.00%) than tthat in control group (20.00%) and CINⅠ(35.23%) with significant difference, and there were no significant differences between other groups;The positive rate and transcription level of HPV E6/E7 mRNA in HSIL (high grade squamous intraepi?thelial lesion)and cancer group were significantly higher than normal, ASC(atypical squamous cell carcinoma) and LSIL(low grade squamous intraepithelial lesion) group (P<0.05). Conclusion The transcription level of HPV E6/E7 mRNA may re?flect the activity of the virus and the progression of disease, and could be use as an effective indicator to screen high grade cervical pathological changes and a complementary method of cervical lesion screening.
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Objective To explore the value of the electronic colposcopy Reid Score in diagnosis of cervical lesions and HPV infection in women with HIV infection, so as to find out an inexpensive, convenient and feasible screening methods. Methods 95 cases of HIV-infected women were screened by cervical liquid based cytology, HPV testing, colposcopy and Reid Score. The patients with abnormal results in any one test mentioned above underwent cervical biopsy. The colposcopy was combined with pathological as a gold standard for case-control study. Results There was a statistically signi?cant correlation between colposcopic ndings and histopathological ndings and the score was increased as parallel as malignancy grade (r=0.753,P=0.00) . The specificity of Reid score for high grade CIN was better than high-risk HPV testing for CIN diagnosis and the sensitivity was better than liquid based cytology. Acetic acid staining has relatively high sensitivity and specificity in the diagnosis of cervical lesions. Conclusions Colposcope Reid score for cervical lesions has a predictive value, especially for high grade cervical precancerous lesions. Colposcopy for HIV-positive women cervical cancer screening is an efficient and feasible way, especially for the area where lack of medical resources.
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El cáncer de cuello uterino es el tumor maligno más frecuente en mujeres de Latinoamérica y su agente causal es el virus del papiloma humano (HPV). Recientemente en Paraguay incorporamos el método de captura híbrida II (CH II), el cual detecta 13tipos de HPV de alto riesgo oncogénico (HR-HPV) y proporciona valores relativos de carga viral. El objetivo del estudio fue determinar la carga viral relativa de HR-HPV por CH IIsegún el diagnóstico citológico. Fueron incluidas 566 mujeres (33 + 10 años) atendidas en el Instituto de Investigaciones en Ciencias de la Salud 2006/2009. Fue detectado HRHPVen 43% de las mujeres (241/566), observándose una alta frecuencia del 23% en mujeres con ausencia de lesión intraepitelial (NSIL). Según el diagnóstico citológico, se evidenció una diferencia altamente significativa entre los valores de carga viral relativa(p<0,0001; Kruskal Wallis), observándose un aumento de carga viral relativa de mujeres con NSIL a mujeres con SIL (68 pg/ml en ausencia de SIL; 710 pg/ml para SIL de bajo grado-LSIL y 474 pg/ml para SIL de alto grado-HSIL). No se observó cambio significativo en la carga viral relativa entre LSIL y HSIL (p=0,60; prueba t de Student). Los resultados sugieren que los valores de carga viral relativa proporcionados por CH II pueden ser considerados como un indicador importante en el manejo de mujeres con sospecha de SIL.
Cervical cancer is the most frequent malignant tumor in women of Latin America being human papillomavirus (HPV) the main causative agent. Recently in Paraguay, we incorporated the method of hybrid capture II (CH II) which detects 13 types of HPV ofhigh oncogenic risk (HR-HPV) and provides relative values of viral load. The aim of this study was to determine the frequency and relative viral load of HR-HPV by CH II according to the cytological diagnosis. There were 566 women (33 + 10 years) included in the study that attended the Research Institute in Health Sciences during the period 2006/2009. HR-HPV was detected in 43% of the women (241/566), being observed a high frequency of 23% in women negative to squamous intraepithelial lesions (NSIL). According to the cytological diagnosis, there was a highly significant difference between the values of relative viral load (p <0.0001; Kruskal Wallis), with an increase of relative viral load of women with NSIL to women with SIL (mean values: 68 pg/ml in NSIL; 710 pg/ml in low grade SIL-LSIL and 474 pg/ml in high grade SIL-HSIL). Significant change was not observed in the relative viral load between LSIL and HSIL (p=0.60; Students t test).The results suggest that the values of relative viral load provided by CH II could be considered an important indicator for managing women with suspicion of SIL.
Subject(s)
Viral Load , Uterine Cervical NeoplasmsABSTRACT
Objective To explore the relation ship between the high-risk human papillomavirus(HPV) and prognosis of ovarian carcinomas.Methods In situ hybridization technique was used to examine HPV16/18 DNA in 32 cases of benign ovarian epithelial tumors,25 cases of borderline tumors and 45 cases of ovarian carcinoma.Immunohistochemistry was used to examine the expression of VEGF and ki-67 protein,which compared to usual ovarian tissues. Results (1)The positive rate of HPV16/18 was significantly different between ovarian carcinoma and normal epithelial ovarian tissues or benign epithelial ovarian tumors(P