human papillomavirus (hpv)

人乳头瘤病毒 (HPV)
  • 文章类型: Systematic Review
    背景:在美国,与其他种族/种族群体相比,拉丁美洲人的宫颈癌发病率最高,部分原因是在筛查方面存在显著差异。妨碍获得和参与筛查的社会和结构条件包括语言障碍,关注文档状态,后勤问题(例如,交通运输,有限的门诊时间),以及关于谦虚和滥交的文化信仰。为了克服这些挑战,自我取样用于人乳头瘤病毒(HPV)DNA检测已成为在这一人群中促进宫颈癌筛查的潜在有前景的方法.因此,本系统综述旨在评估美国拉丁裔人群中HPV自我取样的可接受性.
    方法:使用EBSCOhost和PubMed数据库,我们搜索了过去20年(2003-2023年)发表的研究,这些研究描述了拉丁美洲人参与HPV自我取样.11篇文章符合纳入标准。
    结果:大多数研究是在佛罗里达州进行的,加州,波多黎各,是单臂设计,并涉及使用社区卫生工作者和西班牙语材料(例如,小册子)。在整个研究中,大多数参与者报告说,自采样在易用性方面是可以接受的,舒适(缺乏疼痛),隐私,和便利;然而,一些妇女担心自我取样的准确性,或者她们是否正确地进行了样本收集。
    结论:考虑到高可接受性,在面临重大筛查障碍的人群中,自行采集宫颈阴道样本进行HPV检测可能为增强参与宫颈癌筛查提供可行的选择.
    BACKGROUND: Latinas experience the greatest cervical cancer incidence compared with other ethnic/racial groups in the United States (US) due in part to significant disparities in screening uptake. Social and structural conditions that impede access to and participation in screening include language barriers, concerns about documentation status, logistical issues (e.g., transportation, limited clinic hours), and cultural beliefs regarding modesty and promiscuity. To overcome these challenges, self-sampling for human papillomavirus (HPV) DNA testing has emerged as a potentially promising method for promoting cervical cancer screening among this population. Thus, this systematic review aimed to assess the acceptability of HPV self-sampling among US Latinas.
    METHODS: Using EBSCOhost and PubMed databases, we searched for studies published in the past two decades (2003-2023) that described participation in HPV self-sampling among Latinas. Eleven articles met inclusion criteria.
    RESULTS: The majority of studies were conducted in Florida, California, and Puerto Rico, were single-arm designs, and involved the use of community health workers and Spanish-language materials (e.g., brochures). Across studies, the majority of participants reported that self-sampling was acceptable with respect to ease of use, comfort (lack of pain), privacy, and convenience; however, some women were concerned about the accuracy of self-sampling or whether they had performed sample collection correctly.
    CONCLUSIONS: Given the high acceptability, self-collection of cervicovaginal samples for HPV testing may offer a feasible option for enhancing participation in cervical cancer screening in this population that encounters significant barriers to screening.
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  • 文章类型: Journal Article
    宫颈癌筛查的进化历程一直是一个重大的医学成功故事,考虑到它在减少疾病负担方面发挥的重要作用。通过医学界的持续合作,从不起眼但开创性的常规巴氏涂片到目前的自动筛查系统和人乳头瘤病毒(HPV)分子检测,已经取得了重大进展。随着人工智能与筛查技术的融合,我们目前正处于规避手动细胞学读数陷阱和显著提高筛查系统效率的边缘。尽管经历了技术里程碑,高昂的物流和运营成本,除了操作自动化系统的技术诀窍,在宫颈癌筛查计划中广泛采用这些先进技术可能会带来重大的实际挑战。这表明有必要采取针对不同环境的需求和需求的战略,同时牢记其局限性。这篇综述旨在让读者了解宫颈癌筛查计划的整个进化历程,突出每种技术的优点和缺点,并讨论主要全球准则的建议。
    The evolutionary journey of cervical cancer screening has been a major medical success story, considering the substantial role it has played in dwindling the disease burden. Through sustained collaborative efforts within the medical community, significant advances have been made from the humble yet path-breaking conventional Pap smear to the current automated screening systems and human papillomavirus (HPV) molecular testing. With the integration of artificial intelligence into screening techniques, we are currently at the precipice of circumventing the pitfalls of manual cytology readings and improving the efficiency of the screening systems by a significant margin. Despite the technological milestones traversed, the high logistics and operational cost, besides the technical know-how of operating the automated systems, can pose a major practical challenge in the widespread adoption of these advanced techniques in cervical cancer screening programs. This would suggest the need to adopt strategies that are tailored to the demands and needs of the different settings keeping their limitations in mind. This review aims to take the reader through the entire evolutionary journey of cervical cancer screening programs, highlight the individual merits and demerits of each technique, and discuss the recommendations from the major global guidelines.
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  • 文章类型: Journal Article
    人乳头瘤病毒(HPV)是一种常见的性传播感染。尽管疫苗安全有效,摄取仍然是次优的。最近,为了提高疫苗接种率,重点已经转移到大学校园。对于在美国大学校园中接触研究生的努力程度以及该亚人群中的疫苗接种率知之甚少。这篇范围界定综述评估了关于知识的文献,态度,信仰,以及美国研究生和学士后专业学生中关于HPV和HPV疫苗接种的行为。这篇综述还旨在确定进一步研究的领域,以提高机构创建健康规划的能力,以提高其校园的HPV意识和HPV疫苗接种覆盖率。注重知识的出版物,态度,信仰,并纳入了学士学位后学生中有关HPV和HPV疫苗接种的行为。PubMed的系统评价,CINAHL,Embase确定了2562篇文章,56篇文章符合所有纳入标准,被纳入本次范围审查.大多数审查的研究调查了一些知识的组合,态度,行为,以及对医学等专业课程学生的HPV和HPV疫苗的信念。研究设计方法主要是横截面,利用基于网络的调查分发方法。HPV疫苗接种状态和HPV筛查行为主要通过参与者自我报告进行测量。调查学士学位后学生知识的研究有限,态度,信仰,以及HPV和HPV疫苗接种行为。研究人员需要进一步调查研究生的需求,以创建信息和有效的HPV编程。
    Human papillomavirus (HPV) is a common sexually transmitted infection. Despite a safe and effective vaccine, uptake continues to be suboptimal. Recently, focus has moved to college campuses in an effort to increase vaccination rates. Little is known about the extent of efforts to reach graduate students on college campuses in the United States and the vaccination rates within this subpopulation. This scoping review assessed the literature on knowledge, attitudes, beliefs, and behaviors about HPV and HPV vaccination among graduate and post-baccalaureate professional students in the United States. This review also aims to identify areas for further research to improve institutions\' abilities to create health programming to increase HPV awareness and HPV vaccination coverage on their campuses. Publications focusing on knowledge, attitudes, beliefs, and behaviors about HPV and HPV vaccination in post-baccalaureate students were included. The systematic review of PubMed, CINAHL, and Embase identified 2562 articles, and 56 articles met all inclusion criteria and were included in this scoping review. A majority of the reviewed studies investigated some combination of knowledge, attitudes, behaviors, and beliefs about HPV and the HPV vaccine in students in professional programs such as medicine. Study design approaches were primarily cross-sectional, utilizing web-based survey distribution methods. HPV vaccination status and HPV screening behaviors were primarily measured through participant self-report. There is limited research investigating post-baccalaureate student knowledge, attitudes, beliefs, and behaviors about HPV and HPV vaccination. There is a need for researchers to further investigate the needs of graduate students to create informative and effective HPV programming.
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  • 文章类型: Journal Article
    人乳头瘤病毒(HPV)的致癌潜力已被广泛认可与多种类型的癌症有关。这项调查的目的是对有关HPV与各种类型癌症之间相关性的现有证据进行全面评估。如宫颈,结肠,卵巢,头颈部癌症,沙特阿拉伯王国(KSA)。遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目,以进行系统的文献检索,旨在鉴定探索HPV与特定癌症之间相关性的研究。像WebofScience这样的数据库,Embase,PubMed,科克伦图书馆一直被查询到2023年5月。获得了相关文献,信息被提取,并对方法的严谨性进行了评价。高危型HPV,即HPV-16和HPV-18被检测为KSA中最常见的变异。该地区相当比例的宫颈癌病例被发现与HPV感染有关。分子测试提供了证据,证明了HPV感染与结肠息肉以及结直肠癌之间的联系。这一发现表明HPV在这些医学病症的病因中可能具有合理的作用。基因分型和整合分析的结果表明,HPV与卵巢癌的发展之间可能存在相关性。此外,在这一特定地理区域,与HPV相关的头颈部鳞状细胞癌的患病率显著降低.这项研究提出了有说服力的发现,建立了HPV和宫颈癌之间的联系,并提出了与结肠鳞状细胞癌的合理相关性。卵巢,头和脖子。上述结果强调了对HPV在所述恶性肿瘤的发作和进展中的功能进行额外调查的必要性。有必要进行进一步的研究,以增强我们对HPV在这些肿瘤中的作用的理解。
    The oncogenic potential of human papillomavirus (HPV) has been widely acknowledged in relation to multiple types of cancer. The objective of this investigation was to conduct a comprehensive assessment of the available evidence pertaining to the correlation between HPV and various types of cancer, such as cervical, colon, ovarian, and head and neck cancers, in the Kingdom of Saudi Arabia (KSA). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were complied with to conduct a systematic literature search aimed at identifying studies that explore the correlation between HPV and the specified cancers. Databases such as Web of Science, Embase, PubMed, and the Cochrane Library were queried up until May of 2023. Relevant literature was obtained, information was extracted, and the methodological rigor was evaluated. The high-risk HPV, namely HPV-16 and HPV-18, were detected as the most prevalent variants in KSA. A significant proportion of cervical cancer cases in the region were found to be associated HPV infection. The molecular tests have furnished evidence that establishes a connection between HPV infection and colonic polyps as well as colorectal cancer. This finding suggests that HPV may have a plausible role in the etiology of these medical conditions. The results of genotyping and integration analyses suggest a probable correlation between HPV and the development of ovarian cancer. Additionally, the prevalence of head and neck squamous cell cancer related to HPV was notably reduced in this particular geographical area. This study presents persuasive findings that establish a connection between HPV and cervical cancer and proposes plausible correlations with squamous cell carcinomas in the colon, ovaries, and head and neck. The aforementioned results emphasize the necessity for additional inquiry into the function of HPV in the onset and advancement of said malignancies. Further investigations are necessary to augment our comprehension of the role of HPV in these neoplasms.
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  • 文章类型: Meta-Analysis
    我们打算更新人乳头瘤病毒(HPV)的流行和p16INK4a阳性口咽鳞状细胞癌(SCC),并按地理区域计算口咽SCC的HPV归因分数(AF)。我们搜查了Medline,Embase,和Cochrane图书馆,以确定2021年12月28日前在口咽SCC中单独或一起发表的HPV患病率和p16INK4a阳性的研究.包括使用基于广谱PCR的测试方法报告类型特异性HPVDNA流行的研究。我们估计了合并的HPV患病率,类型特异性HPV患病率,和p16INK4a阳性。按地理区域计算HPV的AF。我们的分析包括134项研究,包括12139例病例。口咽SCC的合并HPV患病率估计为48.1%(95%置信区间[CI]43.2-53.0)。HPV患病率因地理区域而异,口咽SCC中HPV患病率最高的是北美(72.6%,95%CI63.8-80.6)。在HPV阳性病例中,HPV16是最常见的类型,患病率为40.2%(95%CI35.7-44.7)。在HPV阳性和HPV16阳性的口咽SCC病例中,p16INK4a阳性为87.2%(95%CI81.6-91.2)和91.7%(84.3-97.2)。在北美,HPV和HPV16的AF最高,分别为69.6%(95%CI53.0-91.5)和63.0(48.0-82.7)。相当比例的口咽SCC可归因于HPV。HPV16占HPV阳性口咽SCC病例的大多数。这些发现强调了HPV疫苗在预防相当大比例的口咽SCC病例中的重要性。
    We intended to update human papillomavirus (HPV) prevalence and p16INK4a positivity in oropharyngeal squamous cell carcinomars (SCC), and calculate HPV attributable fraction (AF) for oropharyngeal SCC by geographic region. We searched Medline, Embase, and the Cochrane Library to identify published studies of HPV prevalence and p16INK4a positivity alone or together in oropharyngeal SCC before December 28, 2021. Studies that reported type-specific HPV DNA prevalence using broad-spectrum PCR-based testing methods were included. We estimated pooled HPV prevalence, type-specific HPV prevalence, and p16INK4a positivity. AF of HPV was calculated by geographic region. One hundred and thirty-four studies including 12 139 cases were included in our analysis. The pooled HPV prevalence estimate for oropharyngeal SCC was 48.1% (95% confidence interval [CI] 43.2-53.0). HPV prevalence varied significantly by geographic region, and the highest HPV prevalence in oropharyngeal SCC was noted in North America (72.6%, 95% CI 63.8-80.6). Among HPV positive cases, HPV 16 was the most common type with a prevalence of 40.2% (95% CI 35.7-44.7). The pooled p16INK4a positivity in HPV positive and HPV16 positive oropharyngeal SCC cases was 87.2% (95% CI 81.6-91.2) and 91.7% (84.3-97.2). The highest AFs of HPV and HPV16 were noted in North America at 69.6% (95% CI 53.0-91.5) and 63.0% (48.0-82.7). [Correction added on 31 October 2023, after first online publication: the percentage symbol (%) was missing and has been added to 63.0% (48.0-82.7) in the Abstract and Conclusion.] A significant proportion of oropharyngeal SCC was attributable to HPV. HPV16 accounts for the majority of HPV positive oropharyngeal SCC cases. These findings highlight the importance of HPV vaccination in the prevention of a substantial proportion of oropharyngeal SCC cases.
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  • 文章类型: Journal Article
    头颈癌是全世界发病率和死亡率的重要来源。每个肿瘤的个体遗传组成可以帮助确定治疗过程,并可以帮助临床医生预测预后。非侵入性工具来确定这些肿瘤的遗传状态,尤其是p16(人乳头瘤病毒(HPV))状态可能被证明对临床医生和外科医生极具价值.放射组学领域是放射学实践的新兴领域,旨在提供可以从放射学图像中得出的定量生物标志物,并且可以证明对无创地确定p16状态有用。在这次审查中,我们总结了目前使用影像组学确定头颈部肿瘤HPV状态的证据..
    Head and neck cancers represent a significant source of morbidity and mortality across the world. The individual genetic makeup of each tumor can help to determine the course of treatment and can help clinicians predict prognosis. Non-invasive tools to determine the genetic status of these tumors, particularly p16 (human papillomavirus (HPV)) status could prove extremely valuable to treating clinicians and surgeons. The field of radiomics is a burgeoning area of radiology practice that aims to provide quantitative biomarkers that can be derived from radiological images and could prove useful in determining p16 status non-invasively. In this review, we summarize the current evidence for the use of radiomics to determine the HPV status of head and neck tumors. .
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  • 文章类型: Case Reports
    急性早幼粒细胞白血病(APL)是急性髓系白血病(AML)的一个亚组,虽然不是常见的癌症,它确实构成了急性白血病的一小部分。APL的遗传标志是t(15;17)(q24.1;q21.2)早幼粒细胞白血病/视黄酸受体α(PML/RARA)蛋白。我们介绍了一名患者,该患者曾接受过5-氟尿嘧啶的肛门直肠区域IIIC鳞状细胞癌的先前治疗,丝裂霉素C,和放疗,并在约18个月后发展为治疗相关的急性早幼粒细胞白血病。我们还回顾了APL的临床特征和管理,同时也强调了与治疗相关的APL。虽然不常见,可以从化学放射发展。治疗相关APL的特异性诊断是其自身独特的诊断,但其治疗与原发性APL相同。
    Acute promyelocytic leukemia (APL) is a subgroup of acute myeloid leukemia (AML), and while not a common form of cancer, it does make up a modest portion of acute leukemia. The genetic hallmark of APL is the t(15;17)(q24.1;q21.2) promyelocytic leukemia/retinoic acid receptor alpha (PML/RARA) protein. We present the case of a patient who had undergone prior therapy for stage IIIC squamous cell carcinoma of the anorectal region with 5-fluorouracil, mitomycin C, and radiation and developed therapy-related acute promyelocytic leukemia about 18 months later. We also review the clinical features and management of APL while also highlighting that therapy-related APL, although uncommon, can develop from chemoradiation. The specific diagnosis of therapy-related APL is its own distinct diagnosis, but its treatment remains the same as primary APL.
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  • 文章类型: Journal Article
    尽管已知HPV状态在HPV阳性口咽鳞状细胞癌(OPSCC)的初始治疗中提供改善的预后,目前还不清楚它如何影响接受抢救手术(SS)的患者,历史上存活率很低。这项研究的目的是评估SS对HPV阳性OPSCC局部复发(LRR)患者的作用及其对生存率的影响。我们在2022年10月之前对文献进行了范围审查,包括995名个体。生存终点,例如总生存期(OS),卡普兰-迈耶曲线,和中位复发后生存率,除了人口统计之外,还进行了分析。在所有的研究中,18.8%(6/32)报告了SS患者的任何生存数据,在两项研究中报告最普遍的2年和5年OS。未报告SS的中位复发后生存率。这些发现揭示了HPV阳性OPSCC的SS生存特异性数据的有限且不可预测的报告。有限的生存评估,很难评估该疗法的潜在优势和劣势以指导临床决策.
    Although HPV status is known to provide an improved prognosis in initial treatments of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC), it is unclear how it affects patients who receive salvage surgery (SS), which has historically poor survival rates. The purpose of this study was to evaluate the role of SS for patients with locoregional recurrence (LRR) of HPV-positive OPSCC and its impact survival rates. We conducted a scoping review of literature through October 2022 and included 995 individuals. Survival endpoints, such as overall survival (OS), Kaplan-Meier curves, and median post-recurrence survival, were analyzed in addition to demographics. Of all studies, 18.8% (6/32) reported any survival data for SS patients, with the most prevalent reporting 2- and 5-year OS in two studies. Median post-recurrence survival was not reported for SS. These findings reveal the limited and unpredictable reporting of survival-specific data on SS for HPV-positive OPSCC. With limited survival assessment, it is difficult to assess the potential advantages and disadvantages of this therapy to guide clinical decision-making.
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  • 文章类型: Case Reports
    复发性和难治性细菌性阴道病是一种潜在的危险状况,会影响女性的年龄。我们报告了一名33岁的患者在过去三年中尝试多种治疗方案后出现复发性细菌性阴道病的病例。患者有异位妊娠和多种性传播疾病的重要病史。在女性人群中成功控制这种情况对于预防罕见的并发症至关重要。此外,在长期复发的细菌性阴道病患者中,引入健康的阴道微生物群可能是最佳的治疗方案。
    Recurrent and refractory bacterial vaginosis is a potentially hazardous condition that affects the age-bearing population of women. We report the case of a 33-year-old patient presenting with recurrent bacterial vaginosis after attempting multiple regimens for the past three years. The patient had a history significant for ectopic pregnancy and multiple sexually transmitted diseases. Successfully managing this condition in the female population is crucial to prevent uncommon complications. Furthermore, introducing healthy vaginal microbiota can be the best course of action amongst patients with long-term recurrence of bacterial vaginosis.
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  • 文章类型: Journal Article
    背景:生殖器人乳头瘤病毒(HPV)感染是美国(US)15-25岁年轻人中最普遍的性传播感染。尽管HPV疫苗被推荐用于26岁以下的人群,疫苗完成率仍然很低。
    方法:因此,我们的研究利用行为变化的综合理论领域框架(TDF)系统地确定追赶型HPV疫苗接种的促进因素和障碍.五个数据库-Medline,Embase,CINAHL,ERIC,和PsycINFO于2009年1月至2019年7月进行了实证研究,使用定量和定性方法评估美国高校内18-26岁男性的HPV疫苗摄入量.TDF分析过程包括使用混合演绎-归纳方法提取的内容分析,将数据分析和分类为TDF域/主题和子主题。
    结果:总体而言,选择17项研究进行数据提取。我们确定了影响大学男生HPV疫苗接种行为的11个关键TDF领域:“知识”(82%的纳入研究),“环境背景和资源”(53%),“对后果的信念”(53%),“不切实际的乐观”(50%)和“悲观”(6%),\'情感\'(50%),“社会影响”(50%),“关于能力的信念”(41%),“意向”(24%),\'钢筋\'(18%),“社会职业角色和身份”(12%),和“行为调节”(12%)。影响HPV疫苗摄取的障碍包括缺乏关于HPV感染的知识和意识。HPV疫苗安全性,有效性,副作用,和成本;缺乏健康提供者的建议;缺乏医疗保健和健康保险;HPV感染的感知易感性和严重程度较低;HPV疫苗错误信息;以及关于HPV疫苗接种的社会耻辱和同伴影响。HPV疫苗摄取的促成者包括HPV疫苗的高水平的感知益处。
    结论:我们的研究从理论上确定了影响HPV疫苗接种的因素。这可以为有效的规划提供信息,支持,并实施干预措施,以促进大学/大学环境中高危男性的HPV疫苗接种实践。
    Genital human papillomavirus (HPV) infection is the most prevalent sexually transmitted infection among young adults ages 15-25 years in the United States (US). Although HPV vaccines are recommended for individuals ages through 26 years, vaccine completion rates remain substantially low.
    Accordingly, our study utilized a comprehensive - Theoretical Domains Framework (TDF) of behavior change to systematically identify facilitators and barriers to catch-up HPV vaccinations. Five databases - Medline, Embase, CINAHL, ERIC, and PsycINFO were searched from January 2009 to July 2019 for empirical studies using quantitative and qualitative methods to assess HPV vaccine uptake among males ages 18-26 years within US college and university settings. The TDF analytic process included a content analysis using the mixed deductive-inductive approach to extract, analyze and categorize data into TDF domains/themes and sub-themes.
    Overall, 17 studies were selected for data extraction. We identified eleven key TDF domains that influenced HPV vaccination behavior among college male students: \'knowledge\' (82% of included studies), \'environmental context and resources\' (53%), \'beliefs about consequences\' (53%), \'unrealistic optimism\' (50%) and \'pessimism\' (6%), \'emotion\' (50%), \'social influences\' (50%), \'beliefs about capabilities\' (41%), \'intention\' (24%), \'reinforcement\' (18%), \'social professional role and identity\'(12%), and \'behavioral regulation\' (12%). Barriers influencing HPV vaccine uptake included lack of knowledge and awareness regarding HPV infections, HPV vaccine safety, effectiveness, side effects, and costs; absence of health providers\' recommendations; lack of healthcare and health insurance; low levels of perceived susceptibility and severity for HPV infections; HPV vaccine misinformation; as well as social stigma and peer influences regarding HPV vaccinations. Enablers for HPV vaccine uptake included high levels of perceived benefits for HPV vaccines.
    Our study theoretically identified factors influencing HPV vaccinations. This could inform the efficient planning, support, and implementation of interventions that facilitate catch-up HPV vaccination practices among high-risk males within college/university settings.
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