Human papillomavirus

人乳头瘤病毒
  • 文章类型: Journal Article
    综合分析35-64岁女性人乳头瘤病毒(HPV)和HPV相关宫颈疾病的流行病学特征。
    共纳入了从2018年1月至2023年12月筛查HPV和相关宫颈病变的149,559个脱落的宫颈细胞样本。检测15个高危型和6个低危型HPV基因型的患病率,并对宫颈细胞学进行分析。单个和多个HPV感染的影响被表征,研究了年龄的影响。
    86.60%的女性宫颈细胞学检查正常,而7.13%的女性被诊断为宫颈炎症,0.60%与ASC-US,0.22%与ASC-H,使用LSIL的0.72%,0.49%与HSIL,0.03%与ICC。在54岁的ASC-H组中观察到最高的中位年龄。受过小学教育或以下的女性的阳性率最高。HPV总患病率为8.60%。相对流行的HPV类型是HPV52、58、16、39、51。HPV16,HPV18,HPV58,HPV33和HPV52是ICC患者的top5主要类型。17.41%的女性患有多种HPV感染,最常见的共感染亚型是HPV52,HPV58和HPV16。所有HPV亚型的患病率随年龄增长而增加。在55岁以上的人群中,多重HPV感染占较大比例。在45-49岁和55-59岁的病例中,ICC组的HPV16患病率达到峰值。在患有ICC的40-44岁的年轻个体中观察到HPV33患病率峰值。
    应对HPV33感染采取更多措施。
    UNASSIGNED: To comprehensively analyze the epidemiological features of human papillomavirus (HPV) and HPV-related cervical diseases in females aged 35-64 years.
    UNASSIGNED: A total of 149,559 samples of exfoliated cervical cells screened for HPV and related cervical lesions from January 2018 to December 2023 were enrolled. The prevalence of 15 high-risk and 6 low-risk HPV genotypes were detected, and the cervical cytology were analyzed. The impact of single and multiple HPV infections was characterized, and the effect of age was studied.
    UNASSIGNED: The cervix cytology was normal in 86.60% of the females, while 7.13% of the females were diagnosed with cervix inflammation, 0.60% with ASC-US, 0.22% with ASC-H, 0.72% with LSIL, 0.49% with HSIL, 0.03% with ICC. The highest median age was observed in ASC-H group with 54 years old. Females with primary school education or lower have the highest positive rates. The overall HPV prevalence was 8.60%. The relatively prevalent HPV types were HPV52, 58, 16, 39, 51. HPV16, HPV18, HPV58, HPV33 and HPV52 were the top5 predominant types in ICC patients. 17.41% females suffered from multiple HPV infection with the most frequently co-infection subtypes being HPV52, HPV58 and HPV16. The prevalence of all HPV subtypes increased with age. Multiple HPV infections accounted for a larger proportion in those aged above 55 years. The peak HPV16 prevalence was observed in ICC group in cases aged 45-49 and 55-59. The peak HPV33 prevalence was observed in younger individuals aged 40-44 who developed ICC.
    UNASSIGNED: More action should be taken against HPV33 infection.
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  • 文章类型: Journal Article
    了解不同的人乳头瘤病毒(HPV)类型的区域变异是有价值的,因为它可以有利于研究他们的流行病学,致病性,和进化。出于这个原因,在宫颈细胞学和宫颈癌前/恶性样本正常的女性中,研究了HPV52的E6基因的序列变异。
    使用半巢式PCR和测序分析64个HPV52阳性样品。
    我们的发现表明,所有样本都属于谱系A(61%)或B(39%)。在感染A谱系的样本中,检测到亚谱系A1和A2,亚谱系A1占优势。在谱系和疾病阶段之间没有发现相关性(p>0.05)。
    我们的结果表明,A谱系,亚谱系A1和B谱系在伊朗女性中很常见.然而,需要更多样本量更大的研究来估计HPV52谱系在伊朗宫颈癌女性中的致病性风险.
    UNASSIGNED: Knowing the regional variants of distinct human papillomavirus (HPV) types is valuable as it can be beneficial for studying their epidemiology, pathogenicity, and evolution. For this reason, the sequence variations of the E6 gene of HPV 52 were investigated among women with normal cervical cytology and premalignant/malignant cervical samples.
    UNASSIGNED: Sixty-four HPV 52-positive samples were analyzed using semi-nested PCR and sequencing.
    UNASSIGNED: Our findings showed that all samples belonged to lineage A (61%) or B (39%). Among samples that were infected with the A lineage, sublineages A1 and A2 were detected and sublineage A1 was dominant. No association was found between lineages and stage of disease (p > 0.05).
    UNASSIGNED: Our results revealed that the A lineage, sublineage A1, and B lineage were common in Iranian women. Nevertheless, more studies with larger sample sizes are required to estimate the pathogenicity risk of HPV 52 lineages in Iranian women with cervical cancer.
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  • 文章类型: Journal Article
    在急性呼吸道感染期间,女性可以同时接受人乳头瘤病毒(HPV)和呼吸道疫苗,正如在中国2019年冠状病毒病(COVID-19)大流行期间观察到的那样。然而,很少有研究评估这种同时给药的安全性,这可能会影响HPV疫苗接种计划。本研究分析了同时接种HPV和COVID-19疫苗的安全性和最佳顺序。为此,我们调查了福建省2023年1月至10月接种两种疫苗的女性,中国。在这个过程中,我们通过电话或访谈收集了疫苗接种史和不良事件(AE)数据.参与者被分组为之前,并发,或之后基于他们的疫苗接种顺序。卡方检验,精确的Fisher检验,采用logistic回归分析AEs的发生率及影响疫苗安全性的因素。总的来说,1416名符合条件的参与者被包括在内。尽管HPV疫苗的总体AE风险不受疫苗接种顺序的影响,个体AE在组间有统计学差异,包括疫苗接种部位疼痛(p<0.001)和月经持续时间延长(p=0.003)。根据结果,最佳顺序是在COVID-19疫苗接种后接种HPV疫苗(后组)。这种见解可以指导未来HPV和其他呼吸道传染病的紧急疫苗接种顺序。
    During acute respiratory infections, women may concurrently receive human papillomavirus (HPV) and respiratory vaccines, as observed during the coronavirus disease 2019 (COVID-19) pandemic in China. However, few studies have assessed the safety of such concurrent administration, which could impact HPV vaccination schedules. This study analyzes the safety and optimal sequence of concurrent HPV and COVID-19 vaccinations. For this purpose, we surveyed women with both vaccines from January to October 2023 in Fujian Province, China. During this process, we collected vaccination history and adverse event (AE) data via telephone or interviews. Participants were grouped as Before, Concurrent, or After based on their vaccination sequence. A Chi-squared test, exact Fisher tests, and logistic regression were used to analyze the incidence of AEs and factors influencing vaccine safety. Overall, 1416 eligible participants were included. Although overall AE risk with the HPV vaccine was unaffected by vaccination sequence, individual AEs varied statistically between groups, including pain at the vaccination site (p < 0.001) and prolonged menstruation duration (p = 0.003). Based on the results, the optimal sequence would be to receive the HPV vaccine after the COVID-19 vaccine (After group). This insight may guide future emergency vaccination sequences for HPV and other respiratory infectious diseases.
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  • 文章类型: Journal Article
    目标:寻求HIV暴露前预防(PrEP)的人群不成比例地受到甲型肝炎病毒(HAV)的影响,乙型肝炎病毒(HBV)和人乳头瘤病毒(HPV)。我们在安大略省PrEP队列研究(ON-PrEP)中检查了针对这些感染的免疫/疫苗接种。
    方法:ON-PrEP是来自安大略省10个诊所的HIV阴性PrEP使用者的前瞻性队列。我们描述性分析了针对HAV(IgG反应性)的基线免疫/疫苗接种,HBV(乙型肝炎表面抗体>10)和HPV(自我报告的三剂量疫苗接种)。我们进一步进行了多变量逻辑回归,以确定与基线免疫/疫苗接种相关的特征。我们使用累积发生率函数来描述基线时非免疫参与者的疫苗摄取。
    结果:在633名符合条件的参与者中,59.1%为白色,85.8%为男性,79.6%为同性恋。我们发现了针对HAV的免疫/疫苗接种的基线证据,HBV和HPV在69.2%,有PrEP经验的参与者分别为81.2%和16.8%和58.9%,70.3%和10.4%的PrEP天真的参与者,分别。与基线HAV免疫相关的特征是PrEP持续时间更长(校正OR(aOR)1.41/年,95%CI1.09至1.84),频繁性传播和血源性感染(STBBI)检测(aOR2.38,95%CI1.15至4.92)和HBV免疫(aOR3.53,95%CI2.09至5.98)。与基线HBV免疫相关的特征生活在多伦多(aOR3.54,95%CI1.87至6.70)或渥太华(aOR2.76,95%CI1.41至5.40),自我识别为种族化(AOR2.23,95%CI1.19至4.18),PrEP持续时间更长(AOR1.39/年,95%CI1.02至1.90)和HAV免疫(aOR3.75,95%CI2.19至6.41)。与基线HPV疫苗接种相关的特征是年龄≤26岁(aOR9.28,95%CI2.11至40.77),年收入在6万加元至119万加元之间(AOR3.42,95%CI1.40至8.34),频繁的STBBI检测(aOR7.00,95%CI1.38至35.46)和HAV免疫(aOR6.96,95%CI2.00至24.25)。在那些基线时没有免疫的人中,在有PrEP经验的参与者中,免疫/疫苗接种的总累积概率分别为0.70、0.60和0.53,在PrEP-na-iveHAV参与者中,免疫/疫苗接种的总累积概率分别为0.93、0.80和0.70,HBV和HPV,分别。
    结论:对HAV/HBV的基线免疫是常见的,相当比例的非免疫参与者在随访期间接种了疫苗.然而,HPV疫苗接种并不常见。应继续努力消除HPV疫苗接种的障碍,如成本,纳入临床指南和提供者推荐。
    OBJECTIVE: Populations who seek HIV pre-exposure prophylaxis (PrEP) are disproportionately affected by hepatitis A virus (HAV), hepatitis B virus (HBV) and human papillomavirus (HPV). We examined immunity/vaccination against these infections among participants in the Ontario PrEP cohort study (ON-PrEP).
    METHODS: ON-PrEP is a prospective cohort of HIV-negative PrEP users from 10 Ontario clinics. We descriptively analysed baseline immunity/vaccination against HAV (IgG reactive), HBV (hepatitis B surface antibody >10) and HPV (self-reported three-dose vaccination). We further performed multivariable logistic regression to identify characteristics associated with baseline immunity/vaccination. We used cumulative incidence functions to describe vaccine uptake among participants non-immune at baseline.
    RESULTS: Of 633 eligible participants, 59.1% were white, 85.8% were male and 79.6% were gay. We found baseline evidence of immunity/vaccination against HAV, HBV and HPV in 69.2%, 81.2% and 16.8% of PrEP-experienced participants and 58.9%, 70.3% and 10.4% of PrEP-naïve participants, respectively. Characteristics associated with baseline HAV immunity were greater PrEP duration (adjusted OR (aOR) 1.41/year, 95% CI 1.09 to 1.84), frequent sexually transmitted and bloodborne infection (STBBI) testing (aOR 2.38, 95% CI 1.15 to 4.92) and HBV immunity (aOR 3.53, 95% CI 2.09 to 5.98). Characteristics associated with baseline HBV immunity were living in Toronto (aOR 3.54, 95% CI 1.87 to 6.70) or Ottawa (aOR 2.76, 95% CI 1.41 to 5.40), self-identifying as racialised (aOR 2.23, 95% CI 1.19 to 4.18), greater PrEP duration (aOR 1.39/year, 95% CI 1.02 to 1.90) and HAV immunity (aOR 3.75, 95% CI 2.19 to 6.41). Characteristics associated with baseline HPV vaccination were being aged ≤26 years (aOR 9.28, 95% CI 2.11 to 40.77), annual income between CAD$60 000 and CAD$119 000 (aOR 3.42, 95% CI 1.40 to 8.34), frequent STBBI testing (aOR 7.00, 95% CI 1.38 to 35.46) and HAV immunity (aOR 6.96, 95% CI 2.00 to 24.25). Among those non-immune at baseline, overall cumulative probability of immunity/vaccination was 0.70, 0.60 and 0.53 among PrEP-experienced participants and 0.93, 0.80 and 0.70 among PrEP-naïve participants for HAV, HBV and HPV, respectively.
    CONCLUSIONS: Baseline immunity to HAV/HBV was common, and a sizeable proportion of non-immune participants were vaccinated during follow-up. However, HPV vaccination was uncommon. Continued efforts should be made to remove barriers to HPV vaccination such as cost, inclusion in clinical guidelines and provider recommendation.
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  • 文章类型: Journal Article
    背景:人乳头瘤病毒(HPV)是性传播感染的原因,其中一些病毒具有致癌潜力。HPV疫苗将于2019年9月在喀麦隆推出。我们的研究看了知识,感知,以及人口和医疗保健专业人员对宫颈癌及其疫苗预防的态度。这种方法提供了坚实的基础,除其他外,为引入疫苗制定明确的沟通策略。
    目的:本研究旨在评估在喀麦隆的主要利益相关者(包括卫生工作者和父母)中引入HPV疫苗的可行性和可接受性。
    方法:从2019年3月至5月,我们在中心地区的六个卫生区进行了定性和定量描述性研究。总共招募了257名研究参与者,包括168名家长和89名卫生专业人员;还进行了60次采访,30与父母和30与卫生专业人员。使用IBMSPSSStatisticsforWindows分析收集的定量数据,版本20.0(2011年发布;IBMCorp.,Armonk,纽约,美国);对于定性分析,我们对转录的采访进行了反复的阅读。这项工作使我们能够识别受访者话语中出现的重要主题。
    结果:绝大多数医疗保健专业人员声称知道宫颈癌(93.3%),但只有15.7%的女性医疗保健专业人员声称曾经进行过筛查测试。这些专业人员中有很大一部分具有宫颈癌的实际经验。在父母中,对于非专业观众来说,对这种癌症的了解似乎也相对较高(54.2%),筛查率低(7.1%)。对HPV疫苗作为宫颈癌预防工具的认识非常低:父母中有14.9%,医疗保健专业人员中有44.9%。此外,我们发现,父母中关于HPV疫苗存在的信息仍然很低(83.9%从未听说过);43.8%的医疗保健专业人员在他们的培训学校了解过疫苗.关于HPV疫苗的接受,定量和定性结果指向同一方向。大多数父母赞成通过扩大免疫计划(EPI)开展运动并获得这种新疫苗。然而,他们中的许多人(94.6%)解释说,在做出决定之前,他们想要更多的信息。
    结论:告知和提高公众对宫颈癌的认识,HPV疫苗,和疫苗安全是鼓励公众支持HPV疫苗接种运动的重要措施。
    BACKGROUND: Human papillomaviruses (HPV) are responsible for sexually transmitted infections, and some of these viruses have oncogenic potential. The HPV vaccine is due to be introduced in Cameroon in September 2019. Our study looked at the knowledge, perceptions, and attitudes of the population and healthcare professionals regarding cervical cancer and its vaccine prevention. This approach provides a solid basis for, among other things, developing a clear communication strategy for the introduction of the vaccine.
    OBJECTIVE: This study aimed to assess the feasibility and acceptability of introducing the HPV vaccine in Cameroon among key stakeholders including health workers and parents.
    METHODS: From March to May 2019, we conducted a qualitative and quantitative descriptive study in six health districts in the Centre Region. A total of 257 study participants were recruited, including 168 parents and 89 health professionals; 60 interviews were also conducted, 30 with parents and 30 with health professionals. The quantitative data collected were analyzed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States); for the qualitative analysis, we carried out repeated readings of the transcribed interviews. This work enabled us to identify the significant themes emerging from the interviewees\' discourse.
    RESULTS: The vast majority of healthcare professionals claim to be aware of cervical cancer (93.3%), but only 15.7% of female healthcare professionals claim to have ever carried out a screening test. A significant proportion of these professionals have actual experience of cervical cancer. Among parents, knowledge of this cancer also appears to be relatively high for a lay audience (54.2%), with a low screening rate (7.1%). Awareness of the HPV vaccine as a cervical cancer prevention tool was very low: 14.9% among parents and 44.9% among healthcare professionals. In addition, we found that information about the existence of an HPV vaccine was still very low among parents (83.9% had never heard of it); 43.8% of healthcare professionals had been informed about the vaccine at their training school. As regards acceptance of the HPV vaccine, the quantitative and qualitative results point in the same direction. The majority of parents are in favor of a campaign and access to this new vaccine via the Expanded Program on Immunization (EPI). However, many of them (94.6%) explained that they wanted more information before making a decision.
    CONCLUSIONS: Informing and raising public awareness of cervical cancer, the HPV vaccine, and vaccine safety are essential measures to encourage public support for the HPV vaccination campaign.
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  • 文章类型: Journal Article
    本研究旨在调查知识,态度,和实践(KAP)的人乳头瘤病毒(HPV)和成年女性的自我采样。
    横截面,基于问卷调查的研究纳入了2022年10月14日至2023年3月31日在上海浦东医院就诊的成年女性.问卷包含人口统计信息,知识,态度和实践维度。通过多变量逻辑回归确定与KAP和自我抽样相关的因素。
    共收集了1843份有效问卷。平均知识,态度,分别为10.09±5.60、26.76±3.80和6.24±2.20。城市居民(估计值=0.705,p<0.001),郊区居民(估计值=0.512,p<0.001),以及具有本科及以上学位的个人(估计值=0.535,p<0.001),与良好的知识有关,而缺乏HPV感染史的个体(估计值=-0.461,p<0.001)和已婚个体(估计值=-0.185,p<0.001)不太可能拥有良好的知识。较高的知识分数(估计值=0.087,p<0.001)和具有本科及以上学历的个人(估计值=1.570,p<0.001)与积极态度有关。结婚(估计值=0.291,p=0.049)与良好做法有关,而不进行性活动(估计值=-0.959,p<0.001)或无HPV感染史(估计值=-0.499,p=0.011)则与不良治疗相关.少数群体(OR=2.787,p=0.038)和有多个性伴侣的个体(两个伴侣的OR=2.297,对于三个或三个以上的合伙人,OR=2.767,p=0.020和p=0.022)与自我抽样呈正相关。然而,较高的知识(OR=0.952,p=0.026)和态度评分(OR=0.929,p=0.015)与自我抽样呈负相关.
    人口统计学和行为因素显著影响关于HPV的KAP得分和自我采样行为。城市居住权,高等教育水平,积极的态度,少数民族地位与有利的结果相关,而婚姻和缺乏性活动等因素与不利的做法有关。
    UNASSIGNED: This study aimed to investigate the knowledge, attitude, and practice (KAP) of human papillomavirus (HPV) and self-sampling among adult women.
    UNASSIGNED: The cross-sectional, questionnaire-based study included adult women at Shanghai Pudong Hospital from October 14, 2022, to March 31, 2023. The questionnaire contained demographic information, knowledge, attitude and practice dimensions. Factors associated with KAP and self-sampling were identified by multivariate logistic regression.
    UNASSIGNED: A total of 1843 valid questionnaires were collected. The average knowledge, attitude, and practice score was 10.09 ± 5.60, 26.76 ± 3.80, and 6.24 ± 2.20, respectively. Urban residents (estimate = 0.705, p < 0.001), suburban residents (estimate = 0.512, p < 0.001), as well as individuals with undergraduate degrees and higher (estimate = 0.535, p < 0.001), were associated with good knowledge, while individuals lacking a history of HPV infection (estimate = -0.461, p < 0.001) and married individuals (estimate = -0.185, p < 0.001) were less likely to have good knowledge. Higher knowledge scores (estimate = 0.087, p < 0.001) and individuals with undergraduate education and above (estimate = 1.570, p < 0.001) were associated with a positive attitude. Being married (estimate = 0.291, p = 0.049) was associated with good practice, whereas not engaging in sexual activity (estimate = -0.959, p < 0.001) or lacking a history of HPV infection (estimate = -0.499, p = 0.011) were associated with unfavorable practices. Minorities (OR = 2.787, p = 0.038) and individuals with multiple sexual partners (OR = 2.297 for two partners, OR = 2.767 for three or more partners, p = 0.020 and p = 0.022) were positively associated with self-sampling. However, higher knowledge (OR = 0.952, p = 0.026) and attitude scores (OR = 0.929, p = 0.015) were negatively associated with self-sampling.
    UNASSIGNED: Demographic and behavioral factors significantly influenced KAP scores and self-sampling behaviors regarding HPV. Urban residency, higher education levels, positive attitudes, and minority status correlated with favorable outcomes, while factors like marriage and lack of sexual activity were associated with less favorable practices.
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  • 文章类型: Journal Article
    背景:接受放射疗法治疗的口咽部鳞状细胞癌(OPSCC)患者存在短期和长期毒性,影响生活质量(QOL)。经口机器人手术(TORS)在早期OPSCC的管理中具有确立的作用,但由于与晚期人乳头瘤病毒(HPV)相关的OPSCC相关的淋巴结转移发生率高,因此通常需要术后辅助治疗。为了克服对辅助放射治疗(RT)的需求,建议进行新辅助化疗,然后进行TORS和颈淋巴结清扫术(ND)。本研究旨在评估在完成治疗后12个月内接受新辅助化疗,随后接受TORS和ND的HPV相关OPSCC的QOL是否恢复到基线。
    方法:在蒙特利尔的麦吉尔大学健康中心进行了为期12个月的纵向研究,加拿大,在美国癌症联合委员会第七版III期和IVa期HPV相关OPSCC患者的便利样本中,这些患者接受了新辅助化疗,然后接受了TORS和ND。使用欧洲癌症核心研究和治疗组织以及头颈部延伸模块,在治疗完成后的1、3、6和12个月获得QOL数据。使用配对t检验和混合模型进行重复测量分析,以评估从基线到术后12个月以及随时间的QOL变化。分别。
    结果:接受研究治疗的23例患者(中位年龄58岁)中有19例符合资格标准。OPSCC亚位点为腭扁桃体(n=12)和舌根(n=7)。所有19例患者均按照方案进行治疗,并且在术后多学科小组肿瘤委员会讨论中,根据病理学审查和方案要求,没有人需要辅助RT。将12个月QOL随访评分与治疗前评分在可能受RT影响的指标上进行比较时,没有发现显着差异[例如,吞咽(P=0.7),社会饮食(P=.8),口干症(P=.9)]。
    结论:在HPV相关的OPSCC中,新辅助化疗后的TORS和ND作为最终治疗与良好的QOL结局相关。术后3个月QOL评分恢复至基线,并保持所有测量值,表示返回到正常功能。
    BACKGROUND: Patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with radiation-based therapy suffer from short- and long-term toxicities that affect quality of life (QOL). Transoral robotic surgery (TORS) has an established role in the management of early OPSCC but adjuvant treatment is often indicated postoperatively due to the high incidence of nodal metastasis associated with advanced human papillomavirus (HPV)-related OPSCC. To overcome the need for adjuvant radiation therapy (RT), neoadjuvant chemotherapy followed by TORS and neck dissection (ND) is proposed. This study aimed to assess if QOL in HPV-associated OPSCC receiving neoadjuvant chemotherapy followed by TORS and ND returns to baseline within 12 months of completing treatment.
    METHODS: A 12 month longitudinal study was carried out at McGill University Health Centre in Montreal, Canada, among a convenience sample of patients with American Joint Committee on Cancer Seventh Edition stage III and IVa HPV-related OPSCC who were treated with neoadjuvant chemotherapy followed by TORS and ND. QOL data were obtained pretreatment and at 1, 3, 6, and 12 months following treatment completion using the European Organisation for Research and Treatment of Cancer Core and Head and Neck extension modules. Paired t tests and mixed models for repeated measures analysis were used to assess changes in QOL from baseline to 12 months postoperatively and over time, respectively.
    RESULTS: Nineteen of 23 patients (median age 58 years) who received the study treatment fulfilled the eligibility criteria. OPSCC subsites were palatine tonsil (n = 12) and base of tongue (n = 7). All 19 patients were treated per protocol and none required adjuvant RT as per pathology review and protocol requirements at a postoperative multidisciplinary team tumor board discussion. No significant differences were found when comparing 12 month QOL follow-up scores to pretreatment scores in measures that would likely be affected by RT [eg, swallowing (P = .7), social eating (P = .8), xerostomia (P = .9)].
    CONCLUSIONS: In HPV-related OPSCC, neoadjuvant chemotherapy followed by TORS and ND as definitive treatment is associated with excellent QOL outcomes. Postoperative QOL scores returned to baseline by 3 months and were maintained for all measures, indicating a return to normal function.
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  • 文章类型: Journal Article
    为了确定安全性,容忍度,在肯尼亚感染艾滋病毒(WLWH)的妇女中,在宫颈上皮内瘤变2级或3级(CIN2/3)治疗后,坚持使用阴道内5%氟尿嘧啶(5FU)乳膏作为辅助治疗。
    在肯尼亚的12个WLWH中进行了I期试点试验,2023年3月至2024年2月之间的18-49岁(Clinicaltrials.govNCT05362955)。参与者每隔一周阴道内自我给药2g5FU,共八次应用。使用标准化分级量表评估安全性,依从性使用自我报告进行评估,检查用过的施药器,和称重研究药物。
    平均年龄和CD4计数为43.9岁和781个细胞/mm3,分别。7人(58%)接受过8年级或以下的教育。所有12人都报告了至少一个I级不良事件(AE),1(8%)报告为2级AE,未报告3级或4级AE。增加阴道分泌物(n=9,75%)和刺激(n=5,42%),平均持续时间为3.2天和2.8天,分别,是最常见的AE。提供者观察到的AE包括1级宫颈红斑和浅表擦伤。所有参与者都耐受了所有八种5FU剂量,并证明了96%的依从性。
    在基苏木的WLWH中,CIN2/3治疗后自行施用5FU,肯尼亚,是安全的,可容忍,并与高依从性相关。在撒哈拉以南非洲,需要随机试验来研究辅助5FU是否可以改善治疗结果或作为原发性宫颈癌前病变治疗。自我施用的疗法可能在增加治疗机会方面具有变革性,因此,宫颈癌的二级预防。
    UNASSIGNED: To determine the safety, tolerance, and adherence to self-administered intravaginal 5% fluorouracil (5FU) cream as adjuvant therapy following cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3) treatment among women living with HIV (WLWH) in Kenya.
    UNASSIGNED: A Phase I Pilot trial was performed among 12 WLWH in Kenya, aged 18-49 years between March 2023-February 2024 (ClinicalTrial.gov NCT05362955). Participants self-administered 2g of 5FU intravaginally every other week for eight applications. Safety was assessed using a standardized grading scale, and adherence was evaluated using self-report, inspection of used applicators, and weighing of the study drug.
    UNASSIGNED: The mean age and CD4 count were 43.9 years and 781 cells/mm3, respectively. Seven (58%) had an 8th-grade education or less. All 12 reported at least one grade I adverse event (AE), 1 (8%) reported a grade 2 AE, no grade 3 or 4 AEs were reported. Increased vaginal discharge (n=9, 75%) and irritation (n=5, 42%), with a mean duration of 3.2 and 2.8 days, respectively, were the most commonly reported AEs. Provider-observed AEs included grade 1 cervical erythema and superficial abrasions. All participants tolerated all eight 5FU doses, and 96% adherence was demonstrated.
    UNASSIGNED: Self-administered 5FU following CIN2/3 treatment among WLWH in Kisumu, Kenya, was safe, tolerable, and associated with high adherence. Randomized trials are needed to investigate whether adjuvant 5FU can improve treatment outcomes or serve as primary cervical precancer treatment in sub-Saharan Africa. A self-administered therapy may be transformative in increasing access to treatment and, hence, secondary prevention of cervical cancer.
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  • 文章类型: Journal Article
    背景:癌前病变和宫颈癌的主要筛查技术是人乳头瘤病毒(HPV)检测,和HPV自我取样已被证明在结果的准确性方面与临床医生取样一致,并可能提高宫颈癌筛查率.这项研究的目的是了解意识水平,经验,可接受性,江苏女性对阴道HPV自我取样的偏好,浙江,上海,中国,并分析可能的影响因素,确定实施自抽样的可行性。
    方法:总的来说,1793名妇女被纳入数据分析。使用了自我管理的问卷。除了描述性分析,单变量和多变量分析用于探索社会人口统计学特征之间的关联,宫颈癌筛查史,和意识水平,经验,可接受性,以及对HPV自身样本的偏好。
    结果:参与者对HPV自我取样的认识和经验水平中等。共有88.8%的参与者将可接受性评为“高”,64.2%的人首选自我抽样进行宫颈癌筛查。年龄在45至54岁之间的人表现出对临床医生采样(OR=1.762(1.116-2.163))和自我采样(OR=1.823(1.233-2.697))的偏好。高中以上毕业者(OR=2.305(1.517-3.503),OR=2.432(1.570-3.768),OR=3.258(2.024-5.244))首选临床医生抽样,本科及以上学历者(OR=1.664(1.042-2.657))首选自我抽样。中等收入和高收入个人对这两种抽样方法都没有偏好(OR<1)。
    结论:HPV自采样已被广泛接受,但是意识,经验和偏好需要改进。这些结果可能有助于调整公共卫生策略,以便在预防宫颈癌的国家举措中尽早纳入HPV自采样作为筛查方法。
    BACKGROUND: The primary screening technique for precancerous lesions and cervical cancer is human papillomavirus (HPV) testing, and HPV self-sampling has been shown to be consistent with clinician sampling in terms of the accuracy of the results and may improve cervical cancer screening rates. The aim of this study was to understand the level of awareness, experience, acceptability, and preference for vaginal HPV self-sampling among women in Jiangsu, Zhejiang, and Shanghai, China, and to analyze the possible influencing factors to determine the feasibility of implementing self-sampling.
    METHODS: Overall, 1793 women were included in the data analysis. A self-administered questionnaire was utilized. In addition to descriptive analysis, univariate and multivariate analyses were used to explore the associations between sociodemographic features, history of cervical cancer screening, and the level of awareness, experience, acceptability, and preference for HPV self-samples.
    RESULTS: The participants\' level of awareness of and experience with HPV self-sampling were moderate. A total of 88.8% of participants rated the acceptability as \"high\", and self-sampling was preferred by 64.2% of them for cervical cancer screening. People aged 45 to 54 years showed a preference for both clinician sampling(OR = 1.762 (1.116-2.163)) and self-sampling (OR = 1.823 (1.233-2.697)). Those who had graduated from high school or above (OR = 2.305 (1.517-3.503), OR = 2.432 (1.570-3.768), OR = 3.258 (2.024-5.244)) preferred clinician-sampling, and those with a bachelor\'s degree or above (OR = 1.664 (1.042-2.657)) preferred self-sampling. Middle- and high-income individuals showed no preference for either sampling method (OR < 1).
    CONCLUSIONS: HPV self-sampling is widely accepted, but awareness, experience and preferences need to be improved. These results may help to adjust public health strategies for the early inclusion of HPV self-sampling as a screening method in national initiatives to prevent cervical cancer.
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  • 文章类型: Journal Article
    背景:法国癌症控制策略2021-2030旨在实现80%的人乳头瘤病毒(HPV)疫苗接种覆盖率。自2021年以来,HPV疫苗也推荐给11-14岁的男孩。建议对年龄≤19岁的未接种疫苗的青少年进行追赶疫苗接种。PAPILLON研究使用索赔数据来监测法国人群中HPV疫苗接种率(VCR)的演变。
    方法:描述了2017年至2022年的年度HPVVCR。部分疫苗接种定义为分配至少一个剂量的HPV疫苗接种。根据目前的法国建议,全计划疫苗接种被定义为在18个月内注射两到三剂HPV疫苗。估计11-14岁和15-19岁青少年的年度HPV疫苗起始率。在首次接种疫苗时,估计11至19岁的青少年的累积VCR。
    结果:总体而言,1,773,900名女性和592,167名男性在2017年至2022年之间开始了HPV疫苗接种。67.3%的女性和62.4%的男性在11至14岁之间开始,前两次给药的中位时间为195天至190天,分别。在女孩中,15岁时部分计划疫苗接种的累积接种率从2017年的28.1%增加到2022年的50.9%。同样,16岁时,全计划疫苗接种的累积接种率从2017年的15.5%增加到2022年的33.8%。2022年,男性14岁时的启动率为12.6%,19岁时为1.9%。
    结论:在2017年至2022年期间,该建议针对的女孩中HPV疫苗接种覆盖率增加,但仍然不足。这项研究的结果表明,男孩开始接种疫苗是暂时但有希望的。这项研究将监测为改善疫苗接种而采取的行动的效果,包括自2022年底起将疫苗接种能力扩展到社区药剂师。
    BACKGROUND: The French cancer control strategy 2021-2030 aims to achieve 80 % human papillomavirus (HPV) vaccination coverage. Since 2021, HPV vaccination is also recommended for boys aged 11-14 years, with a catch-up vaccination recommended for unvaccinated adolescents aged ≤19 years. The PAPILLON study used claims data to monitor the evolution of HPV Vaccination Coverage Rate (VCR) in the French population.
    METHODS: The annual HPV VCR was described from 2017 to 2022. Partial vaccination was defined as the dispensing of at least one dose of HPV vaccination. Full scheme vaccination was defined according to the current French recommendations as two or three doses of HPV vaccine over an 18-month period. Annual HPV vaccine initiation rates were estimated on 11-14 and 15-19-year-olds adolescents. Cumulative VCR were estimated on adolescents aged between 11 and 19 years at the time of first vaccination.
    RESULTS: Overall, 1,773,900 females and 592,167 males initiated HPV vaccination between 2017 and 2022. Initiations occurred between 11 and 14 years for 67.3 % of females and 62.4 % of males with a median time between the first two doses of 195 days and 190 days, respectively. In girls, the cumulative vaccination rate for the partial scheme vaccination at 15 y.o. increased from 28.1 % in 2017 to 50.9 % in 2022. Similarly, the cumulative vaccination rate for the full scheme vaccination at 16 y.o. increased from 15.5 % in 2017 to 33.8 % in 2022. In 2022, the initiation rates for males were 12.6 % at age 14 and 1.9 % at age 19.
    CONCLUSIONS: HPV vaccination coverage increased between 2017 and 2022 among girls targeted by the recommendation but remains insufficient. The results of this study show a tentative but promising start to vaccination in boys. This study will monitor the effects of actions taken to improve vaccination, including the extension of vaccination competencies to community pharmacists since end of 2022.
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