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Anales Del Sistema Sanitario de Navarra May 2024This study aimed to assess the effectiveness of high-risk human papillomavirus (HR-HPV) primary testing for cervical cancer screening in China's rural areas.
BACKGROUND
This study aimed to assess the effectiveness of high-risk human papillomavirus (HR-HPV) primary testing for cervical cancer screening in China's rural areas.
METHODS
Women aged 21-64 years were recruited. Cervical cytology was diagnosed following the Bethesda 2001 classification system, HPV infection (HR-HPV, HPV-16, HPV-18, and other 12 genotypes) identified by Cobas-4800, and colposcopy and biopsy performed when required. Primary outcomes were defined as the cumulative incidence of cervical intraepithelial neoplasia grade 2/3/higher (CIN2/3+) and its relative risk at baseline and at the 36-month follow-up.
RESULTS
The study included 9,218 women; mean age was 45.15 years (SD: 8.74); 81% completed the follow-up. The most frequent type of cytological lesions (12.4% ) were ASCUS (8.4%) and LSIL (2.2%). HR-HPV infection (16.3%) was more prevalent in HPV-16 than in HPV-18 (3 vs 1.5%); a positive relationship with the severity of the lesions, from 29.8% in ASCUS to 89.6% in HSIL was found. At baseline, 3.5% of the patients underwent colposcopy; 20% had a positive diagnosis. At the 36-month follow-up, the cumulative incidences of CIN2+ and CIN3+ were higher in women with HR-HPV infection (16.9 vs 0.5% and 8.2 vs 0.2%). The relative risk of CIN2/3+ was lower in HR-HPV-negative women compared to those with a negative cytology at baseline (0.4; 95%CI: 0.3-0.4).
CONCLUSIONS
High-risk HPV-based screening may significantly reduce the risk of CIN2/3+ compared with cytology testing. This may be a new resource for public health demands in China's rural areas.
Topics: Humans; Female; Uterine Cervical Neoplasms; Adult; Middle Aged; China; Early Detection of Cancer; Genotype; Papillomavirus Infections; Young Adult; Uterine Cervical Dysplasia; Cohort Studies; Papillomaviridae; Rural Health; Colposcopy; Rural Population; Human Papillomavirus Viruses
PubMed: 38817086
DOI: 10.23938/ASSN.1065 -
BMC Oral Health May 2024Proliferative verrucous leukoplakia (PVL), distinguished by its malignant transformation rate of 43.87% to 65.8%, stands as the oral potentially malignant disorder with...
BACKGROUND
Proliferative verrucous leukoplakia (PVL), distinguished by its malignant transformation rate of 43.87% to 65.8%, stands as the oral potentially malignant disorder with the highest propensity for malignancy. PVL is marked by distinctive heterogeneity regarding the clinical or histopathological characteristics as well as prognostic factors pertinent to this condition. The purpose of this study is to compile and assess the clinicopathological features, malignant transformation, and associated risk factors in patients diagnosed with PVL.
METHODS
This study is a hospital-based retrospective longitudinal study of 36 patients diagnosed with PVL from 2013 to 2023. We conducted complete clinical and histopathological evaluations of the patients.
RESULTS
The cohort comprised 16 males and 20 females, yielding a male-to-female ratio of 1:1.25. The follow-up period ranged from 8 to 125 months, with an average of 47.50 months. The most common clinical type of lesion was the verrucous form (58.33%), and the gingiva was the most common site (44.44%). Each patient had between 2 to 7 lesions, averaging 3.36 per patient. During the follow-up period, twelve patients (33.3%) developed oral cancer, with an average time to malignant transformation of 35.75 months. Kaplan-Meier survival analysis indicated that patients with complaints of pain, roughness, or a rough sensation, with diabetes, and the presence of cytologic atypia histologically showed a higher risk of malignant transformation (p < 0.05). In this study, the rate of malignant transformation in the treatment group (5/23) was lower than that in the untreated group (7/13), however, no statistically significant difference (p = 0.05).
CONCLUSION
The main complaints of pain, roughness, or foreign body sensation, coupled with cytologic atypia histologically are indicative of an increased risk of malignant transformation in PVL. Further research is needed to elucidate the influence of these clinicopathological parameters on the malignant progression of PVL.
Topics: Humans; Male; Female; Leukoplakia, Oral; Cell Transformation, Neoplastic; Retrospective Studies; Middle Aged; Longitudinal Studies; Aged; Adult; Risk Factors; Mouth Neoplasms; Aged, 80 and over; Precancerous Conditions
PubMed: 38816724
DOI: 10.1186/s12903-024-04360-0 -
PloS One 2024Women living with HIV (WLWH) have high risk of developing cervical cancer. High- risk Human papillomavirus (hrHPV) is the single most important cause of cervical cancer....
BACKGROUND
Women living with HIV (WLWH) have high risk of developing cervical cancer. High- risk Human papillomavirus (hrHPV) is the single most important cause of cervical cancer. Vaccination for and early detection of pre-malignant cervical changes, through cervical cancer screening contributes to prevention of cervical cancer. This study sought to determine the prevalence of HPV among WLWH, genotypes present and the risk factors associated with cervical cancer development.
METHODS AND FINDINGS
An analytical cross-sectional study of 250 sexually active women aged 18 years and above, attending HIV clinic at a tertiary health facility in Accra. Demographic data collection and risk factor assessments were done using interviewer-administered questionnaire, and patient records. Cervical swabs were collected and tested for HPV using real-time PCR assays. Genotype analysis was performed on 92 samples. Descriptive statistics and logistic regression analysis were used to establish associations between hrHPV and risk factors among WLWH. Approximately 60% of study participants tested positive for HPV. The prevalence of hr-HPV among WLH was 44.4%. Factors identified to be protective of hrHPV were employment (AOR = 0.19, 95% CI = 0.06, 0.56, p = 0.003) and highly active antiretroviral therapy (HAART) Tenofovir-Lamivudine-Ritonavir-Lopinavir (TLRL) (AOR = 0.30, 95% CI = 0.09, 0.95, p = 0.04). Women with HIV diagnosis within 6 to10 years (AOR = 4.89, 95% CI = 1.05, 22.70, p = 0.043) and diagnosis >10 years (AOR = 8.25, 95% CI = 1.24, 54.84, p = 0.029) had higher odds of hrHPV. Approximately 25% of samples analysed tested positive for hr-HPV group 1 (genotypes 16, 18, 31, 33, 35, 39, 45,51, 52, 56, 58, 69) and 46.8% for multiple HPV genotypes.
CONCLUSION
A high prevalence of genotypes that include high risk genotypes 16 and 18 and multiple HPV infections was found among WLWH. Almost half of the women screened had high-risk HPV and were prone to cervical cancer without their knowledge. Regular HPV screening is recommended for high-risk patient groups.
Topics: Humans; Female; Adult; Papillomavirus Infections; HIV Infections; Risk Factors; Prevalence; Ghana; Cross-Sectional Studies; Middle Aged; Young Adult; Uterine Cervical Neoplasms; Adolescent; Papillomaviridae; Tertiary Care Centers
PubMed: 38814956
DOI: 10.1371/journal.pone.0303535 -
World Journal of Gastroenterology May 2024Gastric cystica profunda (GCP) is an uncommon but underestimated gastric lesion. Its precancerous potential determines its significance. In addition to previous mucosa...
Gastric cystica profunda (GCP) is an uncommon but underestimated gastric lesion. Its precancerous potential determines its significance. In addition to previous mucosa injury due to operations, biopsy or polypectomy, chronic active and atrophic gastritis may also lead to the development of GCPs. By carefully examining the stomach and taking biopsy samples from the susceptible regions, the stage of atrophy can be determined. Chronic atrophic gastritis is a risk factor for cancer evolvement and it can also contribute to GCPs formation. GCPs frequently occur close to early gastric cancers (EGCs) or EGC can arise from the cystic glands. Endoscopic resection is an effective and minimally invasive treatment in GCP.
Topics: Humans; Biopsy; Chronic Disease; Cysts; Gastric Mucosa; Gastritis, Atrophic; Gastroscopy; Precancerous Conditions; Risk Factors; Stomach Diseases; Stomach Neoplasms
PubMed: 38813049
DOI: 10.3748/wjg.v30.i17.2308 -
Asian Pacific Journal of Cancer... May 2024The prevention of cervical cancer can be achieved by treating high-grade cervical precancerous lesions. Treatment options for cervical precancer include excisional... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
Comparison of Sexual Function after Thermal Ablation Versus Loop Electrosurgical Excision Procedure (LEEP) for Cervical Intraepithelial Neoplasia (CIN 2 and 3): A Randomized Controlled Trial.
BACKGROUND
The prevention of cervical cancer can be achieved by treating high-grade cervical precancerous lesions. Treatment options for cervical precancer include excisional procedures, and ablation treatments. Despite the long pre-invasive course of the disease, literature addressing sexual function post-treatment for cervical pre-invasive lesions is scarce. This study aims to bridge this gap and assess the sexual function and the acceptability, efficacy, safety, and complications of loop electrosurgical excision procedure (LEEP) versus thermal ablation.
METHODS
The prospective open-label randomized controlled trial recruited women aged 22-55 with histologically confirmed Cervical Intraepithelial Neoplasia (CIN) 2 and 3 lesions. Participants were randomly allocated to either thermal ablation or LEEP. All cases were followed up with a Pap smear at three- and six-months post treatment. Sexual health assessments were conducted using a questionnaire at baseline and 3 months post-procedure. Secondary outcome measures included comparison of acceptability, pain, and side effects between the two treatment measures.
RESULTS
Out of 1356 screened cases, 60 were included in the study and randomized in two groups. The groups had similar baseline characteristics. Duration of LEEP was longer than thermal ablation (25.33 vs. 20.67 minutes), with higher pain reported 10 minutes post-procedure in the LEEP group. Three months post-procedure, both groups showed comparable acceptability and symptom relief. Sexual function parameters significantly improved in the thermal ablation group compared to LEEP, including satisfaction, desire, lubrication, flexibility, and ability to reach climax.
CONCLUSION
LEEP and thermal ablation are effective treatments for CIN with similar efficacy at 6 months. Thermal ablation demonstrated advantages in procedure time and post-procedural pain but exhibited varying effects on sexual function, improving satisfaction and desire. In contrast, LEEP showed a decrease in satisfaction and potential alterations in lubrication and flexibility. Larger-sample, longer-term studies are recommended for further insights.
Topics: Humans; Female; Electrosurgery; Adult; Uterine Cervical Dysplasia; Prospective Studies; Uterine Cervical Neoplasms; Middle Aged; Young Adult; Follow-Up Studies; Prognosis; Sexual Behavior; Sexual Dysfunction, Physiological; Ablation Techniques
PubMed: 38809642
DOI: 10.31557/APJCP.2024.25.5.1699 -
Asian Pacific Journal of Cancer... May 2024High-risk human papillomavirus (hrHPV) testing using dry-type self-sampled vaginal specimens is becoming more widespread worldwide due to increased screening uptake....
OBJECTIVE
High-risk human papillomavirus (hrHPV) testing using dry-type self-sampled vaginal specimens is becoming more widespread worldwide due to increased screening uptake. However, for the triage of hrHPV-positive women, a visit to a general practitioner is required for reflex cytology. This study aimed to evaluate the hrHPV detection capability of CellSoft®, a wet-type self-sampling method that also allows for cytology.
METHODS
Thirty-eight women aged 20 years and older were included in the study. The women self-sampled using CellSoft® after using an Evalyn® Brush. PCR-based HPV genotyping was performed on both specimens and hrHPV detection results of both devices were compared. Additionally, cytological exam was performed on CellSoft® samples.
RESULTS
Overall agreement between self-sampling devices for the detection of hrHPV in CellSoft® and Evalyn Brush was observed in 97.4% (37/38) of participants. More hrHPV genotypes were detected with Evalyn Brush than with CellSoft®. Among the 22 CellSoft® hrHPV-positive cases, 11 (47.6%) were atypical squamous cells of undetermined significance or worse.
CONCLUSION
CellSoft® hrHPV genotype detection results were in good agreement with those of Evalyn Brush. CellSoft® provided a sufficient cell volume for HPV testing and cytological evaluation.
Topics: Humans; Female; Papillomavirus Infections; Adult; Papillomaviridae; Genotype; Middle Aged; Vaginal Smears; Specimen Handling; DNA, Viral; Uterine Cervical Neoplasms; Young Adult; Early Detection of Cancer; Follow-Up Studies; Cytodiagnosis; Prognosis; Uterine Cervical Dysplasia; Aged; Human Papillomavirus Viruses; Cytology
PubMed: 38809639
DOI: 10.31557/APJCP.2024.25.5.1673 -
Asian Pacific Journal of Cancer... May 2024To investigate the relationship between preoperative inflammatory markers and recurrence of CIN after loop electrosurgical excision procedure (LEEP).
OBJECTIVES
To investigate the relationship between preoperative inflammatory markers and recurrence of CIN after loop electrosurgical excision procedure (LEEP).
METHODS
A retrospective historical cohort study was conducted at gynecologic oncology unit, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand. Data was collected from medical records of CIN cases from year 2016 to 2021. Inclusion criteria were subjects who were diagnosed of CIN and underwent LEEP with pathologic confirmation and followed up for two years (at 6 months, 1 year, and 2 years). Preoperative complete blood count (CBC) was obtained within one month for calculation as systemic inflammatory values.
RESULTS
One hundred and ten cases of CIN were enrolled. Mean age of participants was 48.1 years old. Three-fourths (83/110) of the participants had histological confirmation as CIN2/3. Sixteen (18/110) and twenty (22/110) percentage of cases had recurrence of disease at 1 and 2 years, respectively. Monocytes /lymphocytes ratio (MLR) and systemic inflammation response index (SIRI) could predict recurrence of CIN within 2 years. MLR more than 0.16 and SIRI more than 0.57 gave the sensitivity and negative predictive value (NPV) at percentage of 77.3/ 81.8 and 91.8/ 90.2, respectively. Combination of MLR and SIRI had sensitivity and NPV at 90.5 and 95.4 percent, respectively. MLR and SIRI could not predict marginal involvement, glandular involvement, and LEEP confirmed CIN 2/3.
CONCLUSION
Pretreatment MLR and SIRI were statistically significant in predicting the recurrence in CIN after post LEEP procedure within 2 years follow up.
Topics: Humans; Female; Uterine Cervical Dysplasia; Electrosurgery; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies; Prognosis; Uterine Cervical Neoplasms; Inflammation; Follow-Up Studies; Adult; Biomarkers, Tumor; Thailand
PubMed: 38809635
DOI: 10.31557/APJCP.2024.25.5.1635 -
Scientific Reports May 2024Cervical cancer (CC) ranks as the fourth most common form of cancer affecting women, manifesting in the cervix. CC is caused by the Human papillomavirus (HPV) infection...
Cervical cancer (CC) ranks as the fourth most common form of cancer affecting women, manifesting in the cervix. CC is caused by the Human papillomavirus (HPV) infection and is eradicated by vaccinating women from an early age. However, limited medical facilities present a significant challenge in mid- or low-income countries. It can improve the survivability rate and be successfully treated if the CC is detected at earlier stages. Current technological improvements allow for cost-effective, more sensitive, and rapid screening and treatment measures for CC. DL techniques are widely adopted for the automated detection of CC. DL techniques and architectures are used to detect CC and provide higher detection performance. This study offers the design of Enhanced Cervical Precancerous Lesions Detection and Classification using the Archimedes Optimization Algorithm with Transfer Learning (CPLDC-AOATL) algorithm. The CPLDC-AOATL algorithm aims to diagnose cervical cancer using medical images. At the preliminary stage, the CPLDC-AOATL technique involves a bilateral filtering (BF) technique to eliminate the noise in the input images. Besides, the CPLDC-AOATL technique applies the Inception-ResNetv2 model for the feature extraction process, and the use of AOA chose the hyperparameters. The CPLDC-AOATL technique involves a bidirectional long short-term memory (BiLSTM) model for the cancer detection process. The experimental outcome of the CPLDC-AOATL technique emphasized the superior accuracy outcome of 99.53% over other existing approaches under a benchmark dataset.
Topics: Humans; Female; Uterine Cervical Neoplasms; Algorithms; Precancerous Conditions; Early Detection of Cancer; Machine Learning
PubMed: 38802525
DOI: 10.1038/s41598-024-62773-x -
Journal of Oral and Maxillofacial... 2024[This corrects the article on p. 237 in vol. 24, PMID: 33456231.].
[This corrects the article on p. 237 in vol. 24, PMID: 33456231.].
PubMed: 38800441
DOI: 10.4103/jomfp.jomfp_97_24