子宫颈癌筛查方法的应用及研究进展

子宫颈癌是妇科常见恶性肿瘤之一,发病率居女性恶性肿瘤第二位。建立可持续、合理、有效的普查方法,早期发现癌前病变是防治宫颈癌的关键。目前宫颈癌筛查方法有宫颈细胞学筛查(巴氏涂片、液基薄层细胞学检测、细胞DNA定量分析技术)、肉眼观察辅以醋酸白和Lugol碘溶液检测法、阴道镜检查、病毒-HPV检测,本文就当前各种筛查方法的应用及研究进展进行概括。     

人乳头瘤病毒感染与宫颈癌的研究进展

宫颈癌是一种严重危害女性健康的恶性肿瘤,其发病率较高,位居女性恶性肿瘤的第二位,仅次于乳腺癌.流行病学治疗显示,99％的宫颈癌患者均感染高危型人乳头瘤病毒(Human papillomavirus,HPV),HPV是宫颈癌的首要病因.近年来,HPV分型检测技术的发展十分迅速,在宫颈癌筛查中与细胞学检测联合应用,对子宫颈病变的早期发现和预防有很重要的意义,可以提高诊断的敏感性,预防宫颈癌的发生和改善宫颈癌患者的预后.本文拟对HPV感染的检测方法与宫颈癌的研究进展做一综述.     

Runx3、Ki-67在宫颈病变中的研究进展

宫颈癌严重威胁女性健康和安全,是导致女性死亡的主要恶性肿瘤之一。近年来我国宫颈癌的发病率正以每年2%-3%的速度增长,因此早期诊断对于预防和治疗宫颈癌具有决定性的意义。Runx3基因是一个新近发现的肿瘤抑制基因,其低表达与多种恶性肿瘤的发生发展有关。Ki-67抗原是一种贯穿表达于增殖期细胞中的核抗原,其指数可以准确反映细胞的增殖情况。研究表明Runx3及Ki-67的表达与宫颈癌的发生发展密切相关。目前宫颈癌筛查中的细胞学检查及hr-HPV检测方法都具有一定的局限性,寻求新的筛查方法已成为研究热点。本文将对Runx3及Ki-67在宫颈癌中的研究进展做一综述。     

宫颈癌高危因素及筛查研究进展

宫颈癌发病率在女性恶性肿瘤占第二位。宫颈癌的高危因素很多,如病毒感染、性行为、宫颈病变等因素。大量的研究已经证实人乳头瘤病毒(Human Papillomavirus HPV)感染是宫颈癌发生的必要条件。近年来,宫颈癌的筛查方法也取得了较大的进展,新发展的薄层液基细胞学(Liquid-based cytology test,LCT)、检测高危型HPVDNA的技术及宫颈癌筛查系统(TruScreen),显著提高了宫颈癌和癌前病变的灵敏性和特异性,从而降低了宫颈癌的发生率。     

宫颈癌中人乳头状瘤病毒检测方法的研究进展

人乳头状瘤病毒(HPV)是宫颈癌的重要致病因子,与宫颈癌的发生密切相关。HPV的检测是宫颈癌细胞学检测方法的重要补充,为宫颈病变的诊断提供重要依据,尤其是对细胞学检查不能确定的或位于边界、退化或持续发展的病变的诊断、随诊、防治有着重要意义,是一种经济有效的诊断、筛查方法,可获得良好的社会效益。     

HPV-DNA 亚型检测联合液基细胞学对宫颈癌 筛查的临床价值

目的:探讨HPV-DNA亚型检测联合液基细胞学对宫颈癌筛查的临床价值.方法:对自愿接受宫颈癌筛查的女性1462例作为研究对象,分别对其进行HPV-DNA亚型检测以及液基细胞学的检查,对于出现阳性的患者进行病理组织学检查.结果:HPV+TCT对宫颈癌早期病变以及癌变的检出率为69.67％明显高于HPV检查的56.28％以及TCT检查的63.89％(P＜0.05);HPV+TCT对GIN Ⅰ、CIN Ⅱ、CINⅢ、癌的检出率分别为91.67％,92.86％、91.67％以及100％.结论:采用HPV-DNA亚型检测联合液基细胞学对宫颈癌筛查,可明显提高其对癌前病变的检出率,是一种高效、简单的检测方法.     

阴道镜检查宫颈原位癌的临床使用价值

严重威胁妇女健康的肿瘤,居首位的当推宫颈癌。在我国,通过大规模普查普治,通过细胞学检查、阴道镜下活检和子宫颈管刮术等措施后,诊断早期宫颈癌与异形上皮取得了较高的准确率。阴道镜检查在妇科是一种很有使用价值的辅助诊断方法。自1925年Hinselmann首先用阴道镜诊断早期宫颈癌以来,在国外已有近六十年的历史,国内应用阴道镜诊断早期宫颈癌的工作从1957年即已开始。它能准确地发现肉眼看不见的病变部位及其范围,大大提高诊断的准确性,使早期病例得     

提高细胞学标本阳性检出率的制片技术探讨

细胞学检查以其简便、快速、经济实用等优势,对肿瘤的早期发现发挥着重要的作用.细胞学的正确诊断对指导临床诊断及治疗也起到决定性作用.细胞学标本包括痰、尿、胸腹水、妇科标本等.高质量的细胞学涂片及染色是获得准确诊断的重要环节.多数细胞学的漏诊与误诊始于低劣的制片和染色技术.重视细胞学的制作质量无疑是提高细胞学阳性检出率的重要保证.     

细胞DNA倍体分析和EBERs原位检测在鼻咽癌早期诊断中的应用

目的　探讨鼻咽脱落细胞进行DNA倍体和EB病毒编码RNA (EBERs)检测在鼻咽癌诊断中的应用。方法　对 38例经细胞学诊断为鼻咽癌和 8例为正常的鼻咽细胞涂片分别进行图像分析测定细胞DNA含量和EB病毒EBERs原位杂交检测。结果　与病理细胞学诊断相比 ,DNA异倍体分析和EBERs检测诊断癌的敏感性分别为 5 0 %和 92 %,其特异性均为 10 0 %;其阴性预测值分别为 30 %和 72 %。结论　与EBERs检测相比 ,DNA异倍体分析的诊断敏感性和阴性预测值较低 ,差异具有显著性 (分别为P <0 0 0 1和P <0 0 5 )。证明在鼻咽细胞学涂片应用EB病毒原位杂交检测诊断鼻咽癌优于应用DNA异倍体分析诊断。与细胞DNA图像分析相比 ,EB病毒原位杂交检测具有客观、实验条件简单等优点 ,在鼻咽癌可疑病人的早期诊断和鉴别诊断上具有重要的实用价值。     

人乳头瘤病毒与宫颈癌关系研究进展

宫颈癌是一种严重危害女性健康的恶性肿瘤,其发病率较高,位居女性恶性肿瘤的第二位,仅次于乳腺癌。自从1977年德国学者ZurHausen等从宫颈癌标本中发现了人乳头瘤病毒(Human papillomavirus HPV)DNA,并推测HPV感染与宫颈癌发生有关后,许多学者对HPV与宫颈癌的相关性进行了大量的研究,并证实HPV感染是宫颈癌发病的必需因素。目前,对于宫颈HPV感染检测有多种手段,其中聚合酶链反应(PCR)和捕获杂交技术在实验室中应用较广泛。在宫颈癌筛查中联合应用HPV检测和细胞学,不仅可以提高敏感性,而且还可以减少随诊频率,从而大大降低了宫颈癌的发生。     

Human papillomavirus (HPV) infection in Southern Africa: prevalence,immunity, and vaccine prospects

Human papillomavirus (HPV) associated cancers are more prevalent in developing countries compared to developed countries. The major cancer caused by HPV is cervical cancer. The humoral immune response to HPV can be a marker of past infection but may also reflect persistent infection and cervical disease. IgA antibodies to HPV in oral fluid were also found to be markers of cervical disease. Cell mediated immunity is important in clearing HPV infection and for regression of the associated lesions: this means that women infected with HIV have a high prevalence of co-infection with HPV. Good cervical screening programmes can control HPV associated cervical neoplasia. However, in countries such as South Africa, where these programmes are inadequate, there is a need for an HPV vaccine. The development of HPV vaccines is reviewed. There is a call for an inexpensive vaccine that will be accessible to the women that do not have access to adequate screening programmes and are therefore at the greatest risk of cervical cancer.     

Clinical relevance of human papillomavirus testing in cytopathology

Cancer of the uterine cervix is the second most common cancer in women worldwide. Currently, cervical screening is based on cytology alone. Because infection with high-risk human papillomavirus types (hrHPVs) is a necessary cause of cervical cancer, it has been postulated that screening might become more efficient when it is based on combined cytology and hrHPV testing. In this review we will discuss the advantages of added HPV tests in cervical cancer screening, as a quality control for false-negative smears, in triage of women with equivocal smears, in follow-up of women treated for CIN3 or cervical cancer and for the detection of cervical adenocarcinoma.     

Comparison of Serum and Tissue Levels of Trace Elements in Different Models of Cervical Cancer

Cervical cancer is a leading cause of death by cancer among women worldwide. It is necessary to develop and refine cervical cancer models to more accurately reflect human tumor type. The relevance of cervical cancer to trace element was studied in this paper. By means of quantitative trace element analysis in models and patients with cervical cancer, the tissue and serum levels of trace elements in papillomaviruses-induced cancer models were more similar to that of patients than the levels in models induced by HeLa cell and methylcholanthrene. The results reflect papillomaviruses model most accurately mimic in vivo carcinogenesis of patients with cervical cancer. It will have a superior predictive value over HeLa cell and methylcholanthrene models in pre-clinical trials. The papillomaviruses-induced cervical cancer can provide more reliable models for testing the efficacy of drugs in treating human cancers.     

女性宫颈癌认知情况、健康行为调查及知晓率的影响因素分析

摘要 目的：调查女性宫颈癌认知情况、健康行为,分析影响患者知晓率的影响因素。方法：选择2018年3月至2020年5月于我院进行检查的女性210例为研究对象,采用问卷调查形式对调查对象宫颈癌认知以及防治宫颈癌健康行为进行调查,采用Logistic回归分析影响宫颈癌认知知晓率的危险因素。结果：本次调查共发放问卷210份,回收问卷205份,有效问卷200份,有效问卷率95.24%。调查对象对宫颈癌检查次数、宫颈癌检查目的、生殖道感染症状认知正确率较高,分别为51.50%、48.00%、45.00%,获取宫颈癌防治知识途径较少,3种以上者比例仅占25.50%。健康行为调查结果显示性生活前后偶尔清洁外阴、人工流产次数为1次、偶尔采取避孕措施、从未参与宫颈癌筛查的女性占比分别为47.50%、41.50%、51.50%、47.00%。单因素分析显示年龄、文化程度、居住地、家庭经济收入、宫颈癌家族史、宫颈癌防治信息获取途径与宫颈癌相关防治知识知晓率有关（P＜0.05）,Logistic回归分析结果显示文化程度低、家庭经济收入低、宫颈癌防治信息获取途径少是影响女性对宫颈癌相关防治知识知晓率的危险因素（P＜0.05）。结论：被调查女性中对宫颈癌认知度偏低,防范意识薄弱,健康行为不足,应加强宫颈癌筛查和防治宣传,以降低宫颈癌发病率。     

Molecular targets of HPV oncoproteins: Potential biomarkers for cervical carcinogenesis

Cervical cancer is the second most common cancer among women worldwide and is responsible for 275,000 deaths each year. Persistent infection with high-risk human papillomavirus (HR-HPV) is an essential factor for the development of cervical cancer. Although the process is not fully understood, molecular mechanisms caused by HPV infection are necessary for its development and reveal a large number of potential biomarkers for diagnosis and prognosis. These molecules are host genes and/or proteins, and cellular microRNAs involved in cell cycle regulation that result from disturbed expression of HR-HPV E5, E6 and E7 oncoproteins. One of the current challenges in medicine is to discover potent biomarkers that can correctly diagnose cervical premalignant lesions and standardize clinical management. Currently, studies are showing that some of these molecules are potential biomarkers of cervical carcinogenesis, and it is possible to carry out a more accurate diagnosis and provide more appropriate follow-up treatment for women with cervical dysplasia. In this paper, we review recent research studies on cell cycle molecules deregulated by HPV infections, as well as their potential use for cervical cancer screening.     

microRNAs: New prognostic,diagnostic, and therapeutic biomarkers in cervical cancer

Cervical cancer is as a kind of cancer beginning from the cervix. Given that cervical cancer could be observed in women who infected with papillomavirus, regular oral contraceptives, and multiple pregnancies. Early detection of cervical cancer is one of the most important aspects of the therapy of this malignancy. Despite several efforts, finding and developing new biomarkers for cervical cancer diagnosis are required. Among various prognostic, diagnostic, and therapeutic biomarkers, miRNA have been emerged as powerful biomarkers for detection, treatment, and monitoring of response to therapy in cervical cancer. Here, we summarized various miRNAs as an employable platform for prognostic, diagnostic, and therapeutic biomarkers in the treatment of cervical cancer.     

西安市雁塔区育龄女性宫颈癌防治知识知晓情况调查及影响因素分析

摘要 目的：调查西安市雁塔区育龄女性宫颈癌防治知识知晓情况,并分析其影响因素。方法：选取2019年3月~2020年7月期间于我院进行健康体检的育龄期女性1500例作为研究对象,采用我院自制的调查问卷对研究对象个人信息、宫颈癌防治知识知晓情况进行调查。分析西安市雁塔区育龄女性宫颈癌防治知识知晓情况的影响因素。结果：共发放调查问卷1500份,收回合格问卷1491份,合格率为99.40%（1491/1500）。西安市雁塔区育龄女性宫颈癌防治知识总体知晓率为34.14%（509/1491）。将知晓5项及其以上宫颈癌防治知识的受试者509例纳为知晓组,知晓5项以下的982例作为知晓不足组。单因素分析结果显示：两组在文化程度、年龄、宫颈癌家族病史、家庭月收入、居住地、职业、既往生殖病史、接受过宫颈癌知识宣教、5年内体检史方面对比差异有统计学意义（P<0.05）。多因素Logistic回归分析发现：家庭月收入<5000元、文化程度为初中及以下、接受过宫颈癌知识宣教、既往生殖病史、5年内体检史均是西安市雁塔区育龄女性宫颈癌防治知识知晓情况的影响因素（P＜0.05）。结论：西安市雁塔区育龄女性具有较低的宫颈癌防治知识总体知晓率,且既往生殖病史、家庭人均月收入、文化程度等均为其宫颈癌防治知识知晓情况影响因素,当地相关部门可结合相关影响因素开展针对性的健康教育,以提高当地育龄女性对宫颈癌防治知识的认知。     

Cervical cancer incidence and mortality in New Mexico's Hispanics,American Indians,and non-Hispanic whites.

High rates of cervical cancer were reported in New Mexico in the early 1970s, with especially high rates for minority women. We examined data collected from 1970 to 1987 for invasive cervical cancer and cervical carcinoma in situ for New Mexico''s Hispanic, American Indian, and non-Hispanic white women to determine whether changes had occurred in cervical cancer rates since earlier reports. To further characterize the epidemiology of cervical cancer in New Mexico, we reviewed state vital statistics for cervical cancer deaths occurring between 1958 and 1987. From 1970 to 1987, the incidence for invasive cervical cancer among Hispanic (18.9 per 100,000 person-years) and American Indian women (22.0 per 100,000 person-years) was about double that for non-Hispanic white women (10.3 per 100,000). The incidence in each ethnic group decreased over time for both invasive cancer and carcinoma in situ when the data were examined by 2 time periods (1970 to 1978 and 1979 to 1987). These decreases were most dramatic for invasive cervical cancer. Cervical cancer-related death rates for Hispanics and non-Hispanic whites also decreased from 1958 to 1987. Although our data reflect declines in cervical cancer rates during the study period, further rate decreases, especially for minority women, remain an important public health goal in New Mexico.     

Contextual determinants of participation in cervical cancer screening in France, 2010

BackgroundSome contextual factors associated with participation in cervical cancer screening are reported in the literature, but few studies have examined their combined effect. Our objective was to assess the role of contextual characteristics, separately and in combination, in participation in cervical cancer screening in France.MethodsMarginal Poisson regression models – taking into account the correlation between women in a given commune – were conducted using data from the Baromètre Santé 2010 survey. The characteristics of the commune of residence of the women studied were the potential spatial accessibility to general practitioners (GP) and gynecologists, the agglomeration category, and the socioeconomic level.ResultsThe analyses were performed in 3380 women, 88.2% of whom were up to date with their cervical cancer screening. Once the individual characteristics were taken into account, the screening participation rate was similar in all the communes, with the exception of those with poor access to a gynecologist and good access to a GP, where the rate was 6% lower (95%CI: 0.5–11%) than in the communes with good access to both GP and gynecologist. The same association with accessibility was observed in small agglomerations. Compared to women living in the more advantaged communes, the screening participation rate was 8% (2–12%) lower in those living in the more disadvantaged ones, except when accessibility to both types of physician was high.DiscussionWe observed an association between potential spatial accessibility to care in women’s residential communities and their cervical cancer screening practices, in particular in small agglomerations, rural communes, and more disadvantaged communes.     

Predicting mortality from cervical cancer after negative smear test results.

OBJECTIVE--To assess the relative protection against death from cervical cancer after two or more negative smear test results and compare it with the protection against invasive cancer estimated by an International Agency for Research on Cancer (IARC) working group in an analysis of data from 10 large screening programmes. DESIGN--Comparison of risk of death from cervical cancer after two or more negative smear results with the risk in unscreened women by using a model constructed with data from the British Columbia screening programme. MAIN OUTCOME MEASURES--Mortality from and incidence of invasive cancer. RESULTS--In women with two negative smear results estimates of protection against cervical cancer were about 50% higher when lethal invasive cancer was used as the criterion rather than all invasive cancer. This difference was due to these women being more likely to attend for further tests at which invasive cancer could be detected: screen detected cancer has a better prognosis than clinically diagnosed cancer. Screening intervals could be longer than three years: screening women aged 35-64 every five years was predicted to result in a 90% reduction in mortality from cervical cancer. CONCLUSION--Because protection from mortality is higher than protection from disease and because of the high costs and negative side effects of frequent screening, screening intervals should be longer than three years.