Economic burden of patients with cervical cancer and precancerous lesions / 预防医学

Objective @#To investigate the economic burden of cervical cancer and precancerous lesions, so as to provide the evidence for improving the management of cervical cancer and formulating the policies for reducing the economic burden of cervical cancer and precancerous lesions. @*Methods@#The hospitalized patients with cervical cancer and precancerous lesions were recruited from four hospitals in Xinjiang Uygur Autonomous Region from September 2020 to June 2021. The direct medical expenditures, direct non-medical expenditures, duration of absence from work in patients and their family members as carers were collected using a questionnaire designed by the Cancer Hospital of the Chinese Academy of Medical Sciences, and the economic burdens of cervical cancer and precancerous lesions were estimated. The factors affecting the economic burden of cervical cancer were identified using a multivariable linear regression model.@*Results@#Totally 265 patients with cervical cancer and precancerous lesions were included, with an average age of ( 49.80±10.07 ) years. There were 170 patients with cervical cancer, including 64 cases with stage I, 79 cases with stage II, and 27 cases with stages III/Ⅳ, and 95 patients with precancerous lesions, including 33 cases with low-grade squamous intraepithelial lesion ( LSIL ) and 62 cases with high-grade squamous intraepithelial lesion ( HSIL ). The median economic burdens (interquartile range) were 11 481 ( 4 523 ), 17 850 ( 9 096 ), 112 883 ( 59 623 ), 150 875 ( 105 206 ) and 197 842 ( 61 844 ) Yuan per patient among cases with LSIL, HSIL, and stage I, II and III/Ⅳ cervical cancer, respectively, among which the direct medical expenditures accounted for 85.89% to 93.86%. The median economic burdens (interquartile range) were 708 ( 1 711 ), 11 678 (6 590), 2 557 ( 19 472 ), and 14 943 ( 27 773 ) Yuan per patient with precancerous lesions, and were 910 (1 530), 105 770 ( 91 019 ), 39 765 ( 30 490 ), and 146 445 ( 123 039 ) Yuan per patient with cervical cancer during the diagnostic phase, the clinical treatment phase, the follow-up phase, and in total, respectively. Multivariable linear regression analysis results showed that pathological stage ( β'=0.202, P=0.003 ) and duration of hospital stay ( β'=0.695, P<0.001 ) correlated with the economic burden among patients with cervical cancer. @*Conclusion@#There is a high economic burden among patients with cervical cancer and precancerous lesions. Advanced pathological stage and long duration of hospital stay may increase the economic burden among cervical cancer patients.

p16 gene CpG methylation in cervical squamous cell carcinoma and HPV16 infection in Uyghur women / 中南大学学报(医学版)

OBJECTIVE@#To determine the correlation between p16 gene CpG methylation sites in the promoter region and HPV16 infection in cervical squamous cell carcinoma in Xinjiang Uyghur women.@*METHODS@#MALDI-TOF MS was used quantitatively to analyze p16 gene promotor methylation status of CpG islands in 20 cervix squamous cell carcinomas and 20 corresponding non-cancerous tissues in Uyghur women. HPV16 infection was detected by polymerase chain reaction (PCR) in both groups.@*RESULTS@#Among the 16 CpG sites in the p16 gene promoter region, CpG1-2 and CpG 6 sites were different between the 2 groups, and the levels of CpG1-2 and CpG6 methylation sites in the cervical squamous cell carcinoma were higher than those in the control group. The presence of HPV16 infection was significantly different between the cervix squamous cell carcinoma tissue and non-cancerous tissues (P<0.05). There was no significant correlation between p16 gene CpG methylation sites and HPV16 infection of cervical squamous cell carcinoma in Uyghur women.@*CONCLUSION@#P16 gene CpG 1-2, CpG 6 hypermethylation and HPV16, which are independent of one another, play an important role in cervical squamous cell carcinogenesis in Uyghur women.

Clinical study of different forms of hystero scopic surgery for endometrial polyps / 中华妇产科杂志

Objective To investigate the curative effects of different types of hysteroscopic surgery for endometrial polyps. Methods A total of 327 cases by different ways of hysteroscopic surgery for endometrial polyps from Nov 1999 to Nov 2004 were followed up. The mean age was (40?6) yea rs. The mean follow-up was( 3.0?0.6) years. Among 228 polyps patients in s exual maturity without desire of maintaining fertility, 53 (group A) underwent p olypectomy with electrosurgical vaporization, and 175 cases (group B) did polype ctomy with endometrial resection. Fifty-four (group C) cases (19 cases of infe rtility), who desired future childbearing, did polypectomy with endometrial rese ction of superficial layer near the polyps. Forty-five postmenopausal patients(group D) did polypectomy with endometrial coagulation. Results The time of operation: group A (15.1?0.8) second,group B (19.7?0.7) s econd,group C (20.9?0.7) second,and group D (22.1?0.8) second. None of polyps recurred for the patients of groups A and D after operation, and the recu rrent rate of groups B and C was 1.7% and 7.4%. There were no cases with amen orrhea in group C, who hoped to keep the function of fertility, but the recurren t rate of polyps was higher than other three groups. Of 19 cases of infertility , 14 cases became pregnant after the surgery. Conclusion It is feasible to select different hysteroscop ic surgery for endometrial polyps,according to different ages and the desire of childbearing of the patients.