Prevalence of premalignant cervical lesions among women in community-based screening program using visual inspection with acetic acid in Metro Manila / Philippine Journal of Obstetrics and Gynecology

Background@#Cervical cancer remains a health-care burden in our country. Majority of women afflicted with this cancer are diagnosed in advanced stage. Several groups like the Philippine Society for Cervical Pathology and Colposcopy (PSCPC) have put forth efforts to decrease and eventually eliminate cervical cancer through improvement in level of awareness on the disease and community-based cervical cancer screening programs using visual inspection using acetic acid (VIA). Data on the prevalence of premalignant lesions using this screening method are limited in our country. Thus, the initiative of the society (PSCPC) to embark on this study. @*Objective@#The objective of this study was to determine the prevalence of premalignant cervical lesions among women screened in community-based screening program using VIA in Metro Manila.@*Methodology@#A retrospective cross-sectional study with collection of data from medical records of cervical screening programs done by the PSCPC from March 2017 to December 2019 was done. VIA was done for screening. All VIA-positive women underwent colposcopy and those with abnormal findings had colposcopically guided cervical punch biopsy.@*Results@#A total of 1072 women were screened with a positivity rate of 14.6%. One hundred and fifty-six women were VIA positive and 79 of these women underwent colposcopically guided biopsy. Premalignant cervical lesions were seen in 21 women. The prevalence rate of premalignant cervical lesions in VIA-positive women was 13.5%. The prevalence of premalignant cervical lesions among all women screened was 2%. Risk factors associated with premalignant lesions were early coitarche and smoking.@*Conclusion@#The prevalence of premalignant cervical lesions among women who underwent community-based cervical cancer screening using VIA is lower compared to other studies at 2%.

Clinical significance of high-risk HPV-DNA detection combined with TCT in screening and follow-up of cervical lesions / 上海预防医学

ObjectiveTo explore the application value of high-risk HPV-DNA detection combined with TCT in cervical lesion screening and follow-up. MethodsThis study was conducted from February 2019 to February 2021. During this period， 241 subjects who were the patients referred from the primary community hospitals to the center for re-examination of cervical lesions. Of which 80 were patients with cervical intraepithelial neoplasia. Liquid-based cytology （TCT） technology was used to examine the cervical cytological morphology. The second-generation high-throughput sequencing technology and time-of-flight mass spectrometry technology， independently developed by BGI， were used to screen for HPV-DNA typing. At the same time， biopsy sampling was carried out， and the final pathological diagnosis was made. TCT detection and combined HPV-DNA detection were performed on 80 patients to compare the relationship between TCT alone and TCT/HPV-DNA combined test for the diagnosis and prognosis of CIN Ⅱ and CIN Ⅲ. Follow-up was conducted， and the HPV infection and TCT were re-tested. ResultsAmong the 80 cases of cervical intraepithelial neoplasia， 41 cases （51.25%） were between 35 and 44 years old， higher than the other age groups （P<0.001）. Compared with either TCT or HPV-DNA， TCT combined with HPV-DNA had obvious advantages in sensitivity， specificity， positive predictive value， and negative predictive value （P<0.05）. The recurrence rate in CIN Ⅱ and CIN Ⅲ groups was 9.52% and 16.67% respectively after 18 months of the follow-up. ConclusionTCT detection plays a positive role in cervical pre-cancer screening. By combining high-risk HPV-DNA typing and TCT detection， the detection values of sensitivity and specificity are significantly higher， which can improve the accuracy of cervical lesion screening and is of great significance for the follow-up work.

Meta-Analysis and Systematic Review of the Relationship between Cervical Lesions, HPV and Vaginal Community State Type

Background: Chronic HPV infection is a precursor of cervical cancer, which is largely caused by dysregulation of vaginal flora and other factors like abnormal H2O2, neuraminidase and insufficient vaginal hygiene. The relationship between HPV-induced cancer and vaginal microbiota is involved in the viral chronicity and also influences the disease prognosis. A meta-analysis system was used to evaluate the relationship between cervical lesions, HPV and vaginal microenvironment. Methods: PubMed, Web of Science, Cochrane and Embase databases were searched for relevant literature published from 2016 to December 2020. According to the inclusion and exclusion criteria, literature screening, data extraction and quality evaluation were carried out, and stata16 statistical software was used for Meta-analysis and systematic evaluation. Results: The overall relative risk of CST in 95% CI: 0.76-1.4, LSIL group compared with normal cytology group was 0.81. The overall relative risk of CST in the HSIL group and cervical cancer group was 0.77 and 1.26, respectively. It was found that there was publication bias in the HPV positive group (p-value of Begg and Egger were 0.067 and 0.247) and cervical cancer group (p-value of Begg and Egger were 0.677 and 0.457 respectively). There was a significant difference in CST III between HPV positive group and the LSIL group. Conclusion: Cervical lesions and HPV are related to the increase of vaginal microbial diversity, and HPV and LSIL groups are related to CST III, while HSIL and cervical cancer groups are related to CSTIV, which has a certain guiding significance for early clinical diagnosis, but further large-scale studies are needed to confirm our findings.

Human papillomavirus type 58 infection and integration in exfoliated cervical cells / 西安交通大学学报(医学版)

【Objective】 To detect the types of human papillomavirus （HPV） infection in exfoliated cervical cells to screen patients with early cervical lesions through HPV infection； analyze the viral load and integration sites of HPV58 positive specimens to explore the relationship of HPV58 viral load and integration status with cervical lesions in the hope of providing a scientific basis for the prevention and treatment of cervical lesions. 【Methods】 The exfoliated cervical cells and their clinicopathological data were collected， and genome DNA and total RNA were extracted from the collected specimen. HPV infections were detected using MY09/11 of HPVL1 region general primers and HPV58 was detected using HPV58 E6 specific primers. The copy numbers of HPV58 E6， E2 and human housekeeper gene β-actin were detected by quantitative fluorescence PCR， and the integration status of HPV58 was determined by the ratio of E2 to E6. At the same time， the position of HPV58 integrated into the host chromosome was analyzed through oncogene transcription amplification. 【Results】 Totally 295 HPV positive cases were detected in 1 269 exfoliated cervical cell samples， with the total infection rate of 23.2%. Among them 34 HPV58 positive were detected， which consisted of 4 samples of pure episome， 8 samples of integration， and 22 cases of mixture （both integration and episome）. Statistical analysis showed no significant correlation of the degree of cervical lesions with the viral load and integration status of HPV58. Eight HPV58 samples were integrated into chromosomes 1， 2， 5， 8， and 17， respectively. 【Conclusion】 HPV positive rate was 23.2% in the exfoliated cervical cells， the HPV infection rate increased with the aggravation of cervical lesions. Patients with early cervical lesions can be screened through high-risk HPV infection.

Three-year evaluation of different adhesion strategies in non-carious cervical lesion restorations: a randomized clinical trial

Abstract: Objective: To evaluate non-carious cervical lesions (NCCLs) restored with different adhesion strategies. Methodology: This is a prospective, randomized, double-blind, split-mouth study. An adhesive restorative system (Single Bond Universal/Filtek Z350XT - SBU) was evaluated both without and with selective enamel conditioning (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic acid pretreatment (EDTA; E-RMGIC). In total, 200 restorations, placed in 50 patients, were evaluated at baseline and at a 3-year follow-up using the modified United States Public Health Service (USPHS) criteria. Data were analyzed using the two-proportion equality test, multinomial logistic regression, Wilcoxon test, and Kaplan-Meier survival curves. Results: In total, 42 (84%) patients returned for the 3-year follow-up. SBU showed restoration losses statistically different from RMGIC. Retention was also statistically different in SBU between baseline and the 3-year follow-up. Marginal defects and surface texture were statistically significant for all groups in the period studied, except for the surface texture of SBU and the marginal integrity in E-RMGIC. We observed no statistically significant difference in wear, secondary caries, anatomical form, surface staining, and color over time. Recession degree was the only factor to influence retention rates. Cumulative survival (%) was 89, 98, 98, and 95.3, for SBU, SE-SBU, RMGIC, and E-RMGIC, respectively, without significant differences among them. There was a statistically significant difference between survival curves; however, multiple comparison procedures found no statistical differences. Conclusion: Selective enamel etching affected the retention of non-carious cervical restorations. Adhesion using EDTA and resin-modified glass-ionomer cements delayed marginal defects over time. The degree of gingival recession influenced retention rates. Resin composite restorations showed initial marginal defects, and ionomer restorations, reduced surface luster. EDTA pre-treatment followed by resin-modified glass-ionomer cements may be a promising adhesion strategy for NCCL restorations.

Lesão Cervical não cariosa: uma abordagem clínica e terapêutica / Non-carious cervical injury: a clinical and therapeutic approach

As lesões cervicais não-cariosas (LCNCs) são problemas frequentes nos consultórios odontológicos. Possuem etiologia multifatorial e se caracterizam pela perda de esmalte na região cervical dos dentes, causando deficiência tanto funcional, quanto estética. Como consequência dessas lesões, existe a hipersensibilidade dentária, causada pela presença de fluídos no interior dos túbulos dentinários que atingem as terminações nervosas. Nesse sentido, o objetivo desta revisão de literatura foi realizar uma abordagem acerca das LCNCs, evidenciando os fatores etiológicos, suas consequências e a importância do correto diagnóstico e remoção do agente causador para a realização dos diferentes métodos de tratamentos. Diante dessa realidade, o tratamento varia de acordo com o diagnóstico do aparecimento dessas lesões, sejam elas causadas por fatores intrínsecos ou extrínsecos ou a união de ambos. Sendo de fundamental importância o controle dos mesmos para o sucesso do tratamento e uma maior longevidade das estruturas dentárias.

Non-Carious Cervical Injuries (NCCIs) are frequent problems in dental offices. They have a multifactorial etiology and are characterized by the loss of enamel in the cervical region of the teeth, causing both functional and aesthetic deficiencies. Because of these injuries, there is tooth hypersensitivity, caused by the presence of fluids inside the dentinal tubules that reach nerve endings. In this sense, the objective of this literature review was to conduct an approach about NCCI, highlighting the etiological factors, their consequences and the importance of the correct diagnosis and removal of the causative agent for the realization of the different treatment methods. In view of this reality, treatment varies according to the diagnosis of the appearance of these lesions, whether they are caused by intrinsic or extrinsic factors or the union of both. Being of fundamental importance the control of the same for the success of the treatment and a greater longevity of the dental structures.

Modified tunnel technique applied in the treatment of gingival recessions with non-carious cervical lesion / 华西口腔医学杂志

OBJECTIVE@#This study aimed to investigate the clinical effect of modified tunnel technique (MTUN) in the treatment of gingival recession with non-carious cervical lesion (NCCL).@*METHODS@#Forty-two teeth with Miller I degree gingival recession were divided into the NCCL group or control group depending on whether NCCL was present. Both groups were treated with MTUN plus subepithelial connective tissue. The periodontal probing depth (PD), gingival recession height (GRH), gingival recession width (GRW), attached gingival width (AGW), and clinical attachment loss (CAL) were recorded before and at 3 and 6 months after operation. The mean root coverage (MRC) at 6 months after operation was calculated and analyzed. A root coverage esthetic scoring system was used to record aesthetic scores.@*RESULTS@#GRH, GRW, and CAL of the two groups after surgery were significantly lower than those before surgery, and no significant changes in PD and AGW were observed. The MRC in the NCCL group was 63.40%±28.02%, whereas that in the control group was 67.00%±21.72%; no significant difference between the two groups was found. In terms of aesthetic outcomes, no significant difference between groups was reported.@*CONCLUSIONS@#MTUN can effectively improve gingival recession, and the presence of shallow NCCL (≤1 mm) will not affect the surgical effect of MTUN.

Cervical human papillomavirus infection and cervical lesions in postmenopausal women / 中华全科医师杂志

The status of human papillomavirus (HPV) infection and cervical lesions was analyzed among 20 420 postmenopausal women who participated in gynecological disease screening in Shanghai Minhang district 2017.The infection rate of HPV in postmenopausal women was 8.37％(1 710/20 420),and the infection of high-risk HPV 52,58,16,18 accounted for 95.26％(2 029/2 130).The HPV infection rate was 7.37％ in women aged ≥65 years,and that was 8.62％ in women aged＜65 years(x2=6.640,P=0.010).Among 552 cases with pathological results there were 133 cases of cervical lesions.The top 4 HPV infections in patients with cervical lesions were HPV16,52,58 and 33.The rate of cervical lesions was 22.35％ in ≥65 age group,and 24.93％ in ＜65 age group (P＞0.05).The study suggests that HPV genotyping should be taken into account in gynecological disease screening,and the subjects with high-risk HPV infection should be closely followed up;meanwhile,the age limits of screening population should be appropriately extended.

Human papillomavirus prevalence and genotype distribution among Turkish women with or without cervical lesion

Context: Human papillomavirus (HPV) infection is the main cause of cervical cancer, but the risk is associated with the various HPV genotypes which may be found in women with or without clinical findings. Aims: We aimed to identify HPV prevalence and genotype distribution in women with or without cervical lesions admitted to Gynaecology and Obstetrics Clinics of one of the largest private hospitals in Istanbul between 2013 and 2017. Subjects and Methods: In the present study, cervical cytobrush samples collected from 2464 women with different cytological conditions, and investigated for the presence of HPV, and the different genotypes. Results were evaluated based on the HPV positivity in different cytological findings, and ages. Furthermore, distribution of high-risk (HR) and low-risk (LR) genotypes in different groups was investigated. Results: Among all participants, 1925 (78.1%) was with the normal cytological condition, 354 (14.4%) with ASC-US; 151 (6.1%) with low-grade squamous intraepithelial lesion (LSIL), and 34 (1.4%) with high-grade squamous intraepithelial lesion (HSIL). Our results showed that 649 out of 2464 patients (26.3%) were positive, and 1815 (73.7%) were negative for the presence of HPV. Among 649 positive patients, 223 (34.3%) were found positive for more than one genotype. HPV 16 was found the most common HR-HPV type in ASC-US and LSIL whereas HPV 18 was the most common in HSIL. HPV 6 was found the most common LR-HPV type in ASC-US and LSIL whereas HPV 11 was the most common in HSIL. 26.9% of women <50 years old, and 22.3% of women ?50 years old was positive for HPV. The most common HR-HPV genotype was 16 in both groups with (19%) or without (17%) abnormal cytology. Conclusions: We concluded that HPV prevalence and genotype distribution in women with or without clinical findings is an important predictor of cervical cancer.

Comparison of the clinical effect of the adhesive strategies of universal adhesives in the treatment of non-carious cervical lesions: systematic review and meta-analysis

Objective: to compare, through a systematic review and a meta-analysis, the clinical effect of the adhesive strategies of universal adhesives (UA) in the treatment of non-carious cervical lesions (NCCLs). material and method: a search of the literature was carried out up to january 2018, in the biomedical databases: Pubmed, Embase, Scielo, Science Direct, SIGLE, LILACS, BBO, Google Scholar and the Central Register of Cochrane Clinical Trials. the selection criteria of the studies were as: randomized clinical trials, with a maximum age of 5 years and which report the clinical effects (marginal adaptation, discoloration or marginal staining, presence of secondary caries, postoperative sensitivity, retention and fractures) of the UA in the treatment of NCCLs. the risk of study bias was analyzed through the Cochrane Handbook of systematic reviews of interventions. results: the search strategy resulted in eight articles that reported no difference in marginal adaptation, discoloration or marginal staining, presence of secondary caries and postoperative sensitivity among the adhesive strategies of the UA; however they reported a difference between the retention and the presence of fractures, with the conventional adhesive strategy resulting in a better clinical effect. conclusion: the reviewed literature suggests that the conventional adhesive strategy of UAs results in greater retention and absence of fractures in the treatment of NCCLs.

Association between high risk human papillomavirus DNA load and cervical lesions in different infection status / 中华肿瘤杂志

Objective@#To explore the relationship between high risk HPV (HR-HPV) DNA load and cervical lesions in HR-HPV single/ multiple infections.@*Methods@#Two thousand six hundred and forty-six women from Shanxi, Henan and Xinjiang were recruited into a cervical cancer screening program. Cervical exfoliated cell specimens collected from all of the participants were detected by hybrid capture Ⅱ (HC2), cytological diagnosis was performed according to the Bethesda System, and pathological diagnosis was interpreted using cervical intraepithelial neoplasia (CIN) terminology.Totally 571 cervical specimens were selected and retested to ascertain the HPV types and single/ multiple infections by liner array, a PCR-based method. Semi-quantitative result of HR-HPV DNA load (pg/ml) was estimated by HR HC2.According to the taxonomy of "International Human Papillomavirus Reference Center" , 13 HR-HPVs, including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68, which could be detected by HR HC2 were divided into 4 subgroups.@*Results@#The positive rate of HR-HPV in normal cervix (436 cases), CIN1 (88 cases), CIN2+ (47 cases) group were 29.82%, 85.23% and 100%, respectively. The overall prevalence and median viral load increased coordinating with the pathological degree of cervical lesions (P<0.001). The positive rate and viral load of single infection with HR-HPV belongs to α9 species increased coordinating with the pathological degree of cervical lesions (P<0.05). The viral load of single infection with HR-HPV belongs to α7 species in CIN1 group was higher than those of normal group and CIN2+ group, but without statistical significance (P=0.130). The viral load of multiple infections in CIN1 group was 559.13 pg/ml, significantly higher than 37.73 pg/ml of normal histology (P=0.025), but without significant difference of 332.91 pg/ml of CIN2+ group (P=0.790). The median viral load of HPV single infection in CIN1 group was 167.93 pg/ml, significantly lower than 559.73 pg/ml of multiple infections (P=0.044). The incidence of co-infection with HR-HPVs belong to α9 species was 80.56%, dominated in all patterns of multiple infections and their median viral load increased coordinating with the pathological degree of cervical lesions, but without significant difference (P>0.05). The incidence of co-infection with HR-HPVs belong to α7 species was 66.67%, their median viral load in CIN1 group was higher than that of CIN2+ group, but without statistical significance (P>0.05).@*Conclusions@#Viral loads of single/ multiple infections with HR-HPVs belong to different species show different tendencies coordinating with the pathological degree of cervical lesions. Women with high grade of cervical lesion were dominantly infected with high viral load of HR-HPVs belong to α9 species, and the viral load of multiple infections is higher than that of single infection in low grade of cervical lesion.

Clinicopathological significance of atypical squamous epithelium cells which cannot exclude high-grade squamous intraepithelial lesions in cervical cytology / 肿瘤研究与临床

Objective To investigate clinicopathological significance of atypical squamous epithelium cells which cannot exclude high grade squamous intraepithelial lesions (ASC-H) in the diagnosis of cervical diseases. Methods The results of age, high-risk human papillomavirus DNA (hrHPV DNA) and cervical biopsy in 496 patients with ASC-H from March 2012 to December 2015 in Shanxi Dayi Hospital were analyzed. Results Among 496 ASC-H cases, the proportion of the patients between 40 and 49 years old was the highest [30.8 ％ (153/496)]. HrHPV DNA was detected in 154 cases, and the positive rate was 79.2 ％(122/154), and the positive rate of patients at the age of 18 to 29 years old was the highest [84.2 ％ (16/19)]. The detection rate of cervical intraepithelial neoplasia (CIN) Ⅱand above lesions in 124 cases with cervical biopsy was 66.9 ％ (83/124), including 100 cases with hrHPV DNA positive (80.6 ％) and 24 cases with hrHPV DNA negative (19.4 ％). There were 71 cases (71.0 ％) of CINⅡ, CIN Ⅲ, early squamous carcinoma and squamous cell carcinomas in 100 hrHPV DNA positive patients with cervical biopsy. There were 12 cases (50.0 ％) of CINⅡ/Ⅲ changes in 24 hrHPV DNA negative patients with cervical biopsy, but none in early squamous carcinoma and squamous cell carcinomas was detected, and there was a significant difference between hrHPV DNA positive and negative patients (χ2=3.857, P< 0.05). The positive predictive value, negative predictive value, sensitivity and specificity of hrHPV DNA detection for diagnosis of CINⅡand above lesions were 85.5 ％, 29.3 ％, 71.0 ％ and 50.0 ％, respectively. Conclusions ASC-H strongly predicts CINⅡand above lesions in cervical cytology. The detection of hrHPV DNA has a high positive predictive value for CINⅡand above lesions.

The clinical significance of the second biopsy-cervical conization in the diagnosis and treatment of cervical lesions / 西安交通大学学报(医学版)

ABSTRACT:Objective To investigate the clinical value and application indications of the second biopsy-cervical conization in the diagnosis and treatment of cervical lesions.Methods We selected 413 patients from Department of Gynecology and Obstetrics,General Hospital of Jinan Military Command,who received cervical multi-point biopsy pathology IA for cervical cancer and cervical conization (LEEP knife)of the second biopsy between January 2012 and October 2015.Their data were retrospectively analyzed.Results Compared with cervical multi-point biopsy, the second biopsy-cervical conization after operation had pathological upgrade in 10.65% (44/413),agreement in 73.37% (303/413),and reverse (pathological levels drop and overcast)in 15.98%(66/413).Cervical multi-point biopsy and the second biopsy-cervical conization significantly differed in the diagnosis of cervical low-level intraepithelial lesion,high-grade intraepithelial lesions,and early invasive cancer (IA)(T=21.740,v=3-1=2,P<0.05).Before conization high-risk type HPV infection positive rate was 71.91%(297/413);after operation it was 86.36% (38/44)in upgrade pathology and 70.20% (259/369)in non-upgrade one.And thin prep cytologic test (TCT)showed that the positive rate (ASC-US and above)was about 87.89% (363/413), of which about 11.85% (43/363)was pathological upgrade after conization.The positive rates of high-risk type HPV infection and TCT result (ASC-US and above)in cervical lesions differed significantly between pathological upgrade and non-upgrade after conization (χ2=5.092,P<0.05,χ2=4.476,P<0.05).Conclusion The second biopsy-cervical conization technique as a means of reevaluation of cervical pathological changes in diagnosis and treatment of cervical biopsy under colposcopy can significantly improve diagnosis rate,reduce misdiagnosis and occult cervical cancer,but its clinical application has some indications.

Study on the expression of Ki-67and NF-κB in cervical lesion and their correlation with HPV infection / 国际检验医学杂志

Objective To investigate the expression of Ki-67and NF-κB in cervical lesion and their correlation with HPV infec tion.Methods 70 cases with surgically resected or cervical biopsy (70 cases cervical specimens) were selected as the research object from January 2015 to January 2017 in our hospital.The expression of Ki-67,NF-κB and PCNA were detected by immune cell chemical dyeing method,and making the correlation analysis by Spearman.Results The expression rate of Ki-67,NF-κB and PCNA in CIN and cervical invasive squamous carcinoma tissues were significantly higher than that of chronic cervicitis tissues.Spearman rank correlation analysis showed,there was a positively correlation of Ki-67 and PCNA(r=0.582,P＜0.05),there was a positively correlation of NF-κB and PCNA(r=0.603,P＜0.05),there was a positively correlation of Ki-67 and HPV infection (r=0.601,P＜ 0.05),there was a positively correlation of NF-κB and HPV infection (r=0.596,P＜0.05),here was a positively correlation of PCNA expression and HPV infection(r=0.647,P＜0.05).Conclusion There is a difference of positive expression rate of Ki-67,NFκB in different cervical lesions organizations,and Ki-67,NF-κB are associated with HPV infection,they might be involved in cervical lesions in the process,could be used as indexes for identification of cervical disease,diagnosis and evaluation.

Study on the expression of Ki-67and NF-κB in cervical lesion and their correlation with HPV infection / 国际检验医学杂志

Objective To investigate the expression of Ki-67and NF-κB in cervical lesion and their correlation with HPV infec tion.Methods 70 cases with surgically resected or cervical biopsy (70 cases cervical specimens) were selected as the research object from January 2015 to January 2017 in our hospital.The expression of Ki-67,NF-κB and PCNA were detected by immune cell chemical dyeing method,and making the correlation analysis by Spearman.Results The expression rate of Ki-67,NF-κB and PCNA in CIN and cervical invasive squamous carcinoma tissues were significantly higher than that of chronic cervicitis tissues.Spearman rank correlation analysis showed,there was a positively correlation of Ki-67 and PCNA(r=0.582,P＜0.05),there was a positively correlation of NF-κB and PCNA(r=0.603,P＜0.05),there was a positively correlation of Ki-67 and HPV infection (r=0.601,P＜ 0.05),there was a positively correlation of NF-κB and HPV infection (r=0.596,P＜0.05),here was a positively correlation of PCNA expression and HPV infection(r=0.647,P＜0.05).Conclusion There is a difference of positive expression rate of Ki-67,NFκB in different cervical lesions organizations,and Ki-67,NF-κB are associated with HPV infection,they might be involved in cervical lesions in the process,could be used as indexes for identification of cervical disease,diagnosis and evaluation.

Clinical Efficacy of Cold Knife Conization and Transcervical Resection of Cervical Lesionin the Treatment of Cervical Intraepithelial Neoplasia Ⅱ, Ⅲ / 实用妇产科杂志

Objective:To compare the clinical efficacy of cold knife conization and transcervical resection of cervical lesion in the treatment of cervical intraepithelial neoplasia(CIN) Ⅱ,Ⅲ.Methods:The clinical data of 62 patients with CIN Ⅱ,Ⅲ underwent cold knife conization(CKC group) and 114 underwent transcervical resection of cervical lesion(TCRC group)in Zhujiang Hospital Southern Medical University from Jan 1 st 2010 to Jun 1 st 2014 were collected.The patients' age,pregnant frequency,mean operative time,preoperative pathological grading,blood loss during the operation and after the operation,positive resected margin,cervical stenosis and recurrence were compared between the two groups.Results:There was no difference on the patients age,pregnant frequency and preoperative pathological grading between the two groups(P ＞ 0.05).The mean blood loss during the operation (14.16 ± 14.10 ml)and the mean hospital stays(5.73 ± 1.43 days)of CKC group were significantly different from those of TCRC group(29.80 ±20.55 ml,4.75 ±1.23 days) (P＜0.05).There was no statistical difference on the mean operation time,postoperative vaginal bleeding rate,rate of positive resected margin,cervical stenosis rate and recurrence rate between CKC group and TCRC group (33.15 ± 11.42 min vs 33.18 ±14.61 min,33.9％ vs 21.1％,3.2％ vs 5.3％,4.8％ vs 4.4％,4.8％ vs 3.5％,respectively) (P＞0.05).The concordance rate of pre-operation and post operation pathological results of CKC group and TCRC group was 74.2％ (46/62) and 72.8％ (83/114) respectively,both kappa values were ＜ 0.75.Conclusions;Both CKC and TCRCT are safe as well as effective in the treatment of high-grade cervical intraepithelial neoplasia.Compared with CKC,TCRC has the advantage of short hospital stay,while much intraoperative blood loss,which calls for intraoperative attention.

Clinical application value of gene chip for detecting HPV DNA genotype in cervical lesions screening / 国际检验医学杂志

Objective To investigate the clinical application value of gene chip method for detecting human papilloma virus (HPV) DNA genotype .Methods A total of 372 samples of HPV genotype in the gynecological outpatients department of our hos‐pital from September to December 2015 were collected ,including 22 kinds of genotype(18 types of high risk ,4 types of low risk) , meanwhile all samples were performed thinprep cytologic test(TCT) .Results In 372 samples ,223 cases of HPV gene were detec‐ted with the detection rate of 59 .94% ,194 cases(52 .15% ) of high risk type and 194 cases(7 .80% ) of low risk type were detected ;the abnormal rate of TCT was 44 .08% (including atypical hyperplasia ,low‐grade and high‐grade lesion) ,the atypical hyperplasia was 22 .88% ,the detection rate of high‐grade lesion was 5 .10% and which of low‐grade lesion was 18 .01% .In the cervical lesions showing the lesion beyond inflammation ,multiple infection and cervical lesions had significant correlation (P<0 .05) .Conclusion HPV genotyping has higher clinical application in the cervical lesion screening ,moreover which has good correlation with the cyto‐logical change .Conducting HPV genotyping is beneficial to the early screening of cervical lesions .

Correlation between Severity of Cervical Lesions and Methylation of Human Papilloma Virus Type 16 DNA / 中国医科大学学报

Objective To quantifiably measure the methylation frequency of 18 CpG sites in the 3′region of L1 gene and long control region(LCR) gene of HPVl6 DNA,and study the relationship between HPVl6 DNA methylation and severity of cervical lesions. Methods A total of 10 cases Normal/low?grade squamous intraepithelial lesion(Normal/LSIL),10 cases of high?grade squamous intraepithelial lesion(HSIL),and 10 cases of cervical cancer(CC)were recruited for the study. The relationship between severity of cervical lesions and HPV16 DNA methylation was analyzed by bisultlte?pyrosequencing. Results The methylation rate was highest in Normal/LSIL at position 7 089 located in 3′?L1,followed by CC. The low?est was found in HSIL. The difference in methylation percentage among the three lesions was significant(P=0.006). In 7 134,the proportion meth?ylation was also different among three groups(P=0.01),difference in methylation percentage between Normal/LSIL and CC,as well as Normal/LSIL and HSIL was significant(P=0.038,0.017). Conclusion The methylation status of CpG sites 7 089 and 7 134 in the 3′region of L1gene is asso?ciated with the severity of cervical disease. The quantification of HPV DNA methylation can be used for cervical disease screening in clinical samples.

A combined approach to non-carious cervical lesions associated with gingival recession

Non-carious cervical lesions (NCCLs) with gingival recession require specific consideration on both aspects of hard and soft tissue lesion. In the restorative aspect, careful finishing and polishing of the restorations prior to mucogingival surgery is the critical factor contributing to success. Regarding surgery, assessment of the configuration of the lesion and the choice of surgical technique are important factors. The precise diagnosis and the choice of the proper treatment procedure should be made on the basis of both restorative and surgical considerations to ensure the successful treatment of NCCLs.

Influence of non carious cervical lesions depth, loading point application and restoration on stress distribution pattern in lower premolars: a 2D finite element analysis / Influência da profundidade da lesão cervical não cariosa, ponto de aplicação de carga e restauração no padrão de distribuição de tensões em pré-molares inferiores: 2d-análise por elementos finitos

The aim of this study was to analyze the biomechanical behavior of lower premolars regarding the non-carious cervical lesion (NCCL) depth, load type and restoration status, using finite element analysis. Twodimensional virtual model simulating a healthy lower premolar were created using the CAD software. Based on this image, five models were generated: healthy (H), three types of NCCLs: small lesion (SL ­ 0.5 mm deep), medium lesion (ML ­ 1.0 mm), deep lesion (DL ­ 1.5 mm), and restored lesion (RL). The models were export to a CAE software (ANSYS Finite Element Analysis Software), the areas of all structures were plotted and each model was meshed using a control mesh device. All of the virtual models were subjected to two occlusal load types, (100N each): occlusal load (OL) and buccal load (BL) on buccal cusp. The magnitude and the stress distribution were obtained using the von Mises and maximum principal stress criteria (1), in MPa. The quantitative analysis of stress (MPa) was identified at three points of the NCCLs: enamel surface on its upper wall , dentin at the bottom wall and dentin on the lower wall. The results showed a direct relation between sequential removal of cervical structure and higher stress concentration for any groups and for both loads types. For OL the highest value of stress was 8.8 MPa for DL on upper wall of NCCLs.The BL exhibited higher stress values in comparison to the OL for all models.In addtion, the BL was responsible for providing the highest stress accumulation on the bottom wall, 38.2 MPa for DL. The restoration with composite resin was able to restore a stress distribution close to the healthy model, for both load types. In conclusion, the extent of non-carious cervical lesion and loading conditions influenced the stress distribution pattern of lower premolar. The outer load seems to be more critical in affecting the biomechanical behavior of lower premolars, regardless of the lesion size. The restoration of NCCLs with composite resin appears to recover the biomechanical behavior, similar to healthy model.

O objetivo desse estudo foi analisar o comportamento biomecânico de pré-molares inferiores em relação a profundidade da lesão cervical não cariosa (LCNC), tipo de carregamento e condição da restauração, utilizando a análise por elementos finitos. Modelo virtual bidimensional simulando um pré molar inferior hígido foi criado utizando o software de CAD.A partir dessa imagem, cinco modelos foram gerados: hígido (H), três tipos de LCNCs-lesão rasa (SL-0.5 mm de profundidade), lesão média (ML-1.0mm), lesão profunda (DL-1.5mm), e lesão restaurada (RL). Os modelos foram exportados para o software de CAE (ANSYS Software de Análise por Elementos Finitos), as áreas de todas as estruturas foram plotadas e cada modelo foi malhado utilizando um dispositivo controle de malha.Todos os modelos virtuais foram submetidos a dois tipos de carregamento oclusal (100N cada): carregamento oclusal (OL) e carregamento externo (BL) na cúspide vestibular. A intensidade e a distribuição das tensões foram obtidas utilizando os critérios de von Mises e tensão máxima principal (1),em Mpa. A análise quantitativa das tensões (MPa) foi identificada em três pontos das LCNCs: parede superior em esmalte, parede de fundo em dentina e parede inferior em dentina. Os resultados apresentaram uma relação direta entre a remoção sequencial de estrutura na região cervical e os maiores valores de concentração de tensões para todos os grupos e para os dois tipos de carga. Para OL, o maior valor de tensão foi 8.8 MPa para DL na parede superior da LCNCs. O BL exibiu maiores valores de tensão em comparação ao OL para todos os modelos. Além disso, BL foi responsável por promover o maior acúmulo de tensão na parede de fundo, 38.2 MPa para DL. A restauração com resina composta foi capaz de restaurar uma distribuição de tensões similar a do modelo hígido, para ambos os tipos de carga. Em conclusão, a extensão da lesão e o tipo de carregamento influenciaram no padrão de distribuição de tensões de pré-molares inferiores. A carga externa parece ser mais crítica para afetar o comportamento biomecânico de pré-molares inferiores, independente do tamanho da lesão. A restauração das LCNCs com resina composta, parece recuperar o comportamento biomecânico similar ao do modelo hígido.