Subject(s)
Adenocarcinoma, Clear Cell/diagnosis , Diethylstilbestrol , Uterine Cervical Neoplasms/diagnosis , Adenocarcinoma, Clear Cell/etiology , Adenocarcinoma, Clear Cell/therapy , Cervix Uteri/pathology , Child , Fatal Outcome , Female , Humans , Magnetic Resonance Imaging , Pregnancy , Prenatal Exposure Delayed Effects , Uterine Cervical Neoplasms/etiology , Uterine Cervical Neoplasms/therapyABSTRACT
BACKGROUND: The participation of women in cervical cancer screening in Malaysia is low. Self-sampling might be able to overcome this problem.The aim of this study was to assess the reliability of self-sampling for cervical smear in our country. MATERIALS AND METHODS: This cross-sectional study was conducted on 258 community dwelling women from urban and rural settings who participated in health campaigns. In order to reduce the sampling bias, half of the study population performed the self-sampling prior to the physician sampling while the other half performed the self-sampling after the physician sampling, randomly. Acquired samples were assessed for cytological changes as well as HPV DNA detection. RESULTS: The mean age of the subjects was 40.4±11.3 years. The prevalence of abnormal cervical changes was 2.7%. High risk and low risk HPV genotypes were found in 4.0% and 2.7% of the subjects, respectively. A substantial agreement was observed between self-sampling and the physician obtained sampling in cytological diagnosis (k=0.62, 95%CI=0.50, 0.74), micro-organism detection (k=0.77, 95%CI=0.66, 0.88) and detection of hormonal status (k=0.75, 95%CI=0.65, 0.85) as well as detection of high risk (k=0.77, 95%CI=0.4, 0.98) and low risk (K=0.77, 95%CI=0.50, 0.92) HPV. Menopausal state was found to be related with 8.39 times more adequate cell specimens for cytology but 0.13 times less adequate cell specimens for virological assessment. CONCLUSIONS: This study revealed that self-sampling has a good agreement with physician sampling in detecting HPV genotypes. Self-sampling can serve as a tool in HPV screening while it may be useful in detecting cytological abnormalities in Malaysia.
Subject(s)
Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Self Care , Specimen Handling/methods , Uterine Cervical Dysplasia/diagnosis , Uterine Cervical Neoplasms/diagnosis , Vaginal Smears/instrumentation , Adult , Cross-Sectional Studies , DNA, Viral/genetics , Female , Follow-Up Studies , Humans , Middle Aged , Neoplasm Staging , Papillomavirus Infections/epidemiology , Papillomavirus Infections/virology , Physicians , Polymerase Chain Reaction , Prognosis , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/virology , Uterine Cervical Dysplasia/epidemiology , Uterine Cervical Dysplasia/virologyABSTRACT
INTRODUCTION: Gestational hypertension (GH) is a common disorder during pregnancy that can progress to preeclampsia and cause various subsequent fatal complications. A cluster of enzymes, called matrix metalloproteinases (MMPs), and its specific inhibitors, tissue inhibitors of metalloproteinases (TIMPs), have been reported to be involved in the pathophysiology of GH. The purpose of this study was to examine circulating levels of MMP-9, TIMP-1 and TIMP-2 in pregnant women who had GH and those who were normotensive. METHODS: In a case-control study, the total levels of MMP-9, TIMP-1 and TIMP-2 in the sera of 108 pregnant patients were evaluated using enzyme-linked immunosorbent assays. 54 patients with GH (test group) and 64 normotensive pregnant women (control group) were included in the study. RESULTS: While MMP-9 levels showed a high level of expression in the GH group (p = 0.085), TIMP-1 and TIMP-2 levels showed low levels of expression for the same. Weak positive correlations were found on correlation analysis between maternal age and TIMP-1 in the GH group (r = 0.278, p < 0.05), and between gestational age and TIMP-2 in the control group (r = 0.318, p < 0.05). CONCLUSION: Our findings suggest that MMP-9 may be involved in the pathophysiology of GH. It may be of value to further evaluate MMP-9 as a potential biomarker for predicting preeclampsia in pregnant women.
