Uterine Cervical Neoplasms

宫颈肿瘤
  • 文章类型: Journal Article
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    人乳头瘤病毒(HPV)阴性宫颈癌患者的预后明显差于HPV阳性宫颈癌患者。了解这种机制对于预防疾病发展至关重要。在本研究中,构建GV367‑蜗牛家族转录抑制因子2(SNAI2)慢病毒载体,并将其转导到C‑33A细胞中。随后,使用细胞计数试剂盒(CCK)-8方法检测肿瘤细胞的增殖。流式细胞术用于分析肿瘤细胞的细胞周期进程。使用氧化酶测定法检测肿瘤细胞的葡萄糖消耗,并使用β-半乳糖苷酶染色检测肿瘤细胞的衰老。使用逆转录定量PCR和蛋白质印迹法检测p38和ERK1/2的基因表达和活性,分别。成功建立了C‑33A‑SNAI2细胞系。与HeLa和C‑33A‑Wild细胞相比,C‑33A‑SNAI2组G0/G1期细胞的增殖和百分比降低,通过CCK‑8检测(100±0与239.1±58.3vs.39.7±20.1,P<0.01)和流式细胞术(34.0±7.1%vs.46.2±10.6%vs.61.3±5.3%,P<0.05)。与HeLa集团相比,C‑33A‑Wild和C‑33A‑SNAI2组的葡萄糖消耗显著降低(P<0.01)。β-半乳糖苷酶染色结果显示,与C-33A-Wild组相比,C-33A-SNAI2组的β-半乳糖苷酶阳性细胞比例明显降低(P<0.01)。SNAI2的上调增强了p21表达的增加,与C-33A-Wild细胞相比,C-33A细胞中CDK1,尿激酶纤溶酶原激活物受体(u-PAR)和细胞周期蛋白D1的表达降低(P<0.05)。此外,与C‑33A‑Wild和HeLa组相比,C‑33A‑SNAI2组的p38、ERK1/2活性和磷酸化(p)‑ERK1/2/p‑p38比值降低(P<0.05)。总之,SNAI2增强HPV阴性宫颈癌C‑33A细胞休眠,以G0/G1阻滞为特征,通过u‑PAR表达式的下调,和体外p‑ERK1/2和p‑p38MAPK信号通路的活性降低。癌症复发和转移是大多数癌症相关死亡的原因。鉴于SNAI2是增强HPV阴性宫颈癌细胞休眠所必需的,调节这一过程可能促使宫颈肿瘤细胞进入持续休眠状态,这可能是一种潜在的肿瘤治疗方法。
    The prognosis of patients with human papillomavirus (HPV)‑negative cervical cancer is significantly worse than that of patients with HPV‑positive cervical cancer. Understanding the mechanisms of this is crucial for preventing disease evolution. In the present study, the GV367‑snail family transcriptional repressor 2 (SNAI2) lentiviral vector was constructed and transduced into C‑33A cells. Subsequently, the proliferation of tumor cells was detected using the Cell Counting Kit (CCK)‑8 method. Flow cytometry was used to analyze the cell cycle progression of tumor cells. The glucose consumption of tumor cells was detected using an oxidase assay, and the senescence of tumor cells was detected using beta‑galactosidase staining. The gene expression and the activity of p38 and ERK1/2 were detected using reverse transcription‑quantitative PCR and western blotting, respectively. The C‑33A‑SNAI2 cell line was successfully established. Compared with HeLa and C‑33A‑Wild cells, the proliferation and percentage of G0/G1‑phase cells in the C‑33A‑SNAI2 group were decreased, as detected by the CCK‑8 assay (100±0 vs. 239.1±58.3 vs. 39.7±20.1, P<0.01) and flow cytometry (34.0±7.1% vs. 46.2±10.6% vs. 61.3±5.3%, P<0.05). Compared with the HeLa group, the glucose consumption of the C‑33A‑Wild and C‑33A‑SNAI2 groups was significantly decreased (P<0.01). The results of beta‑galactosidase staining showed that the proportion of beta‑galactosidase‑positive cells in the C‑33A‑SNAI2 group was significantly decreased compared with the C‑33A‑Wild group (P<0.01). Upregulation of SNAI2 enhanced the increase in p21 expression, and the decrease in CDK1, urokinase plasminogen activator receptor (u‑PAR) and cyclin D1 expression in C‑33A cells compared with C‑33A‑Wild cells (P<0.05). In addition, the activities of p38, ERK1/2 and the phosphorylated (p)‑ERK1/2/p‑p38 ratio were decreased in the C‑33A‑SNAI2 group compared with the C‑33A‑Wild and HeLa groups (P<0.05). In conclusion, SNAI2 enhanced HPV‑negative cervical cancer C‑33A cell dormancy, which was characterized by G0/G1 arrest, by the downregulation of u‑PAR expression, and a decrease in the activity of the p‑ERK1/2 and p‑p38MAPK signaling pathways in vitro. Cancer recurrence and metastases are responsible for most cancer‑related deaths. Given that SNAI2 is required for enhancing HPV‑negative cervical cancer cell dormancy, regulating this process may promote cervical tumor cells to enter a continuous dormant state, which could be a potential approach for tumor therapy.
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  • 文章类型: Case Reports
    背景:Peutz-Jeghers综合征(PJS)的特征是胃肠道中存在错构瘤性息肉和嘴唇上的粘膜皮肤色素沉着,口腔粘膜,鼻子,手指,和脚趾。女性生殖道的同步粘液性化生和瘤形成(SMMN-FGT)是指在至少两个部位发生多灶性粘液性病变,包括子宫颈,子宫,输卵管,和卵巢,在女性生殖道。SMMN-FGT和PJS是发病率非常低的罕见疾病,尤其是同时发生的时候。
    方法:我们报告了一个病例,其中一名左卵巢有较大肿块的妇女接受了妇科手术,被诊断为宫颈胃型腺癌和子宫内膜粘液性病变,双侧输卵管,和卵巢,即,SMMN-FGT,通过术后石蜡病理学检查。患者因腹胀和增大而求医。妇科超声显示骨盆有多房性囊性肿块,而血清肿瘤标志物在正常范围内,碳水化合物抗原199和碳水化合物抗原125水平轻度升高。宫颈薄层细胞学检查结果为阴性。患者有PJS家族史,皮肤和粘膜有黑点,年龄8岁。由于肠梗阻和肠套叠,她接受了多次部分小肠切除术和胃肠道息肉切除术。她接受了左附件切除术,子宫切除术,右输卵管切除术,大网膜切除,阑尾切除术和右卵巢活检,并接受了6个疗程的洛普加卡铂辅助化疗。基因检测显示丝氨酸苏氨酸激酶11种系杂合突变,治疗后18个月随访期间无复发迹象。
    结论:这是一种罕见的病例,其中PJS并发SMMN-FGT。由于其极端稀有,没有指导方针,但报道的病例似乎表明预后不良。我们回顾性回顾了所有PJS和SMMN-FGT之间的碰撞病例,并探讨了临床特征,病理特征,诊断,治疗方法,两种疾病并存时的预后。目的是加深临床医生对这种疾病的认识,以便早期发现,诊断和治疗。
    BACKGROUND: Peutz-Jeghers syndrome (PJS) is characterized by the presence of hamartomatous polyps in the gastrointestinal tract and mucocutaneous pigmentation on the lips, oral mucosa, nose, fingers, and toes. Synchronous mucinous metaplasia and neoplasia of the female genital tract (SMMN-FGT) refers to the occurrence of multifocal mucinous lesions in at least two sites, including the cervix, uterus, fallopian tubes, and ovaries, in the female genital tract. SMMN-FGT and PJS are rare diseases with a very low incidence, especially when occurring simultaneously.
    METHODS: We report a case in which a woman with a large mass on the left ovary underwent a gynecological surgery and was diagnosed with cervical gastric-type adenocarcinoma and mucinous lesions in the endometrium, bilateral fallopian tubes, and ovary, i.e., SMMN-FGT, by postoperative paraffin pathology. The patient sought medical attention for abdominal distension and enlargement. A gynecological ultrasound revealed a multilocular cystic mass in the pelvis, while serum tumor markers were within normal limits, with mildly elevated carbohydrate antigen 199 and carbohydrate antigen 125 levels. Cervical thin-prep cytology test result was negative. The patient had a family history of PJS with black spots on her skin and mucous membranes since the age of 8 years. She underwent multiple partial small bowel resections and gastrointestinal polypectomy owing to intestinal obstruction and intussusception. She underwent left adnexectomy, hysterectomy, right salpingectomy, greater omental resection, appendectomy and right ovary biopsy, and received six courses of adjuvant chemotherapy with Lopressor plus Carboplatin. Genetic testing revealed a heterozygous serine threonine kinase 11 germline mutation and there were no signs of recurrence during the 18-month follow-up period after treatment.
    CONCLUSIONS: This is a rare case in which PJS was complicated by SMMN-FGT. Owing to its extreme rarity, there are no guidelines, but reported cases appear to indicate a poor prognosis. We retrospectively reviewed all cases of collisions between PJS and SMMN-FGT and explored the clinical features, pathological characteristics, diagnosis, treatment methods, and prognosis when the two diseases coexisted. The aim is to deepen the clinicians\' understanding of this disease for early detection, diagnosis and treatment.
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  • 文章类型: Journal Article
    背景:宫颈癌是女性中第四常见的癌症,90%的宫颈癌相关死亡发生在喀麦隆等低收入和中等收入国家。在低资源环境中,经常使用乙酸进行目视检查以筛查宫颈癌;然而,它的准确性是有限的。为了解决这个问题,瑞士洛桑联邦理工学院和日内瓦大学医院正在合作开发一种基于智能手机的自动图像分类器,该分类器可作为癌症病变的计算机辅助诊断工具。这项研究的主要目的是探索Dschang女性对依靠人工智能使用宫颈癌筛查工具的可接受性和观点。第二个目标是了解女性希望获得的关于这种基于人工智能的筛查工具的信息的首选形式和类型。
    方法:采用定性方法来更好地了解女性的观点。参与者,从农村和城市地区邀请了30至49岁的人,并使用预先测试的采访指南进行了半结构化采访。焦点小组是根据教育水平划分的,以及HPV状态。采访是录音的,转录,并使用ATLAS编码。ti软件。
    结果:共有32名参与者参加了六个焦点小组,38%的参与者接受了小学教育。使用技术接受模型的改编版本对确定的观点进行了分类。影响人工智能可接受性的关键因素包括隐私问题,感知有用性,以及对提供者能力的信任,该工具的准确性以及智能手机的潜在负面影响。
    结论:结果表明,基于人工智能的宫颈癌筛查工具对Dschang中的女性来说几乎是可以接受的。通过确保患者的机密性并提供明确的解释,可以在社区中促进接受,并可以提高对宫颈癌筛查的接受。
    背景:日内瓦州伦理委员会,瑞士(CCER,N°2017-0110和CER修正案N°4)和喀麦隆国家人类健康研究伦理委员会(N°2022/12/1518/CE/CNERSH/SP)。NCT:03757299。
    全球,宫颈癌是女性中第四常见的癌症。然而,90%的由宫颈癌引起的死亡发生在低收入和中等收入国家。不幸的是,传统上在喀麦隆等环境中用于检测宫颈癌的方法缺乏准确性。因此,瑞士联邦理工学院洛桑和日内瓦大学医院的研究人员正在开发一种基于人工智能的计算机辅助诊断工具,以使用智能手机应用程序检测癌前病变。这项研究的目的是探讨基于AI的工具对Dschang妇女进行宫颈癌筛查的可接受性和观点,喀麦隆西部的一个城市。对六个焦点小组和总共32名参与者进行了定性方法。这项研究强调的主要问题与隐私有关,信任医疗保健提供者的能力,该工具的准确性以及智能手机的潜在负面影响。总之,我们的结果表明,使用人工智能的计算机辅助诊断工具在Dschang的女性中大部分是可以接受的,只要保密,他们事先得到了明确的解释。
    BACKGROUND: Cervical cancer is the fourth most frequent cancer among women, with 90% of cervical cancer-related deaths occurring in low- and middle-income countries like Cameroon. Visual inspection with acetic acid is often used in low-resource settings to screen for cervical cancer; however, its accuracy can be limited. To address this issue, the Swiss Federal Institute of Technology Lausanne and the University Hospitals of Geneva are collaborating to develop an automated smartphone-based image classifier that serves as a computer aided diagnosis tool for cancerous lesions. The primary objective of this study is to explore the acceptability and perspectives of women in Dschang regarding the usage of a screening tool for cervical cancer relying on artificial intelligence. A secondary objective is to understand the preferred form and type of information women would like to receive regarding this artificial intelligence-based screening tool.
    METHODS: A qualitative methodology was employed to gain better insight into the women\'s perspectives. Participants, aged between 30 and 49 were invited from both rural and urban regions and semi-structured interviews using a pre-tested interview guide were conducted. The focus groups were divided on the basis of level of education, as well as HPV status. The interviews were audio-recorded, transcribed, and coded using the ATLAS.ti software.
    RESULTS: A total of 32 participants took part in the six focus groups, and 38% of participants had a primary level of education. The perspectives identified were classified using an adapted version of the Technology Acceptance Model. Key factors influencing the acceptability of artificial intelligence include privacy concerns, perceived usefulness, and trust in the competence of providers, accuracy of the tool as well as the potential negative impact of smartphones.
    CONCLUSIONS: The results suggest that an artificial intelligence-based screening tool for cervical cancer is mostly acceptable to the women in Dschang. By ensuring patient confidentiality and by providing clear explanations, acceptance can be fostered in the community and uptake of cervical cancer screening can be improved.
    BACKGROUND: Ethical Cantonal Board of Geneva, Switzerland (CCER, N°2017-0110 and CER-amendment n°4) and Cameroonian National Ethics Committee for Human Health Research (N°2022/12/1518/CE/CNERSH/SP). NCT: 03757299.
    Globally, cervical cancer is the fourth most frequent cancer among women. However, 90% of all deaths caused by cervical cancer occur in low-and middle-income countries. Methods traditionally used in settings like Cameroon to detect cervical cancer unfortunately lack accuracy. Therefore, researchers at the Swiss Federal Institute of Technology Lausanne and the University Hospitals of Geneva are developing an artificial intelligence-based computer aided diagnosis tool to detect pre-cancerous lesions using a smartphone application. The aim of this study was to explore the acceptability and perspectives regarding an AI-based tool for cervical cancer screening for women in Dschang, a city in the west of Cameroon. A qualitative methodology was conducted with six focus groups and a total of 32 participants. The main concerns highlighted by the study are related to privacy, trust in the ability of the healthcare providers, accuracy of the tool as well as the potential negative impact of smartphones. In conclusion, our results show that a computer aided diagnosis tool using artificial intelligence is mostly acceptable to women in Dschang, as long as their confidentiality is preserved, and they are provided with clear explanations beforehand.
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  • 文章类型: Journal Article
    背景:原发性宫颈癌筛查和癌前病变治疗是预防宫颈癌的有效方法。然而,在大多数发展中国家,甚至一些发达国家,人乳头瘤病毒(HPV)疫苗和常规筛查的覆盖率都很低。本研究旨在探索人工智能辅助细胞学(AI)系统在中国宫颈癌高危人群筛查计划中的益处。
    方法:收集2018年至2020年在解放军总医院接受阴道镜检查的女性液基细胞学(LBC)切片1231张。所有妇女都根据阴道镜检查和活检的结果接受了组织学诊断。灵敏度(Se),特异性(Sp),阳性预测值(PPV),负预测值(NPV),假阳性率(FPR),假阴性率(FNR),总体精度(OA),正似然比(PLR),人工智能的负似然比(NLR)和尤登指数(YI),LBC,HPV,LBC+HPV,AI+LBC,计算低度鳞状上皮内病变(LSIL)和高度鳞状上皮内病变(HSIL)阈值的AI+HPV和HPVSeqLBC筛查策略以评估其有效性。进行受试者工作特征(ROC)曲线分析以评估不同筛查策略的诊断价值。
    结果:在LSIL和HSIL阈值下,初级AI单独策略的Se和Sp优于LBC+HPV共检测策略。在筛查策略中,AI策略在LSIL+阈值和HSIL+阈值的YI值最高。在HSIL+阈值处,人工智能战略取得了最好的结果,AUC值为0.621(95%CI,0.587-0.654),而HPV检测结果最差,AUC值为0.521(95%CI,0.484-0.559)。同样,在LSIL+阈值,基于LBC的策略取得了最好的结果,AUC为0.637(95%CI,0.606-0.668),而HPV检测结果最差,AUC为0.524(95%CI,0.491-0.557)。此外,在该阈值下,AI和LBC策略的AUC相似(分别为0.631和0.637).
    结论:这些结果证实,仅AI筛查是诊断HSIL和LSIL的最权威方法,提高阴道镜诊断的准确性,并且比传统的LBC+HPV共检测对患者更有益。
    BACKGROUND: Primary cervical cancer screening and treating precancerous lesions are effective ways to prevent cervical cancer. However, the coverage rates of human papillomavirus (HPV) vaccines and routine screening are low in most developing countries and even some developed countries. This study aimed to explore the benefit of an artificial intelligence-assisted cytology (AI) system in a screening program for a cervical cancer high-risk population in China.
    METHODS: A total of 1231 liquid-based cytology (LBC) slides from women who underwent colposcopy at the Chinese PLA General Hospital from 2018 to 2020 were collected. All women had received a histological diagnosis based on the results of colposcopy and biopsy. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), false-positive rate (FPR), false-negative rate (FNR), overall accuracy (OA), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and Youden index (YI) of the AI, LBC, HPV, LBC + HPV, AI + LBC, AI + HPV and HPV Seq LBC screening strategies at low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) thresholds were calculated to assess their effectiveness. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic values of the different screening strategies.
    RESULTS: The Se and Sp of the primary AI-alone strategy at the LSIL and HSIL thresholds were superior to those of the LBC + HPV cotesting strategy. Among the screening strategies, the YIs of the AI strategy at the LSIL + threshold and HSIL + threshold were the highest. At the HSIL + threshold, the AI strategy achieved the best result, with an AUC value of 0.621 (95% CI, 0.587-0.654), whereas HPV testing achieved the worst result, with an AUC value of 0.521 (95% CI, 0.484-0.559). Similarly, at the LSIL + threshold, the LBC-based strategy achieved the best result, with an AUC of 0.637 (95% CI, 0.606-0.668), whereas HPV testing achieved the worst result, with an AUC of 0.524 (95% CI, 0.491-0.557). Moreover, the AUCs of the AI and LBC strategies at this threshold were similar (0.631 and 0.637, respectively).
    CONCLUSIONS: These results confirmed that AI-only screening was the most authoritative method for diagnosing HSILs and LSILs, improving the accuracy of colposcopy diagnosis, and was more beneficial for patients than traditional LBC + HPV cotesting.
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  • 文章类型: Journal Article
    宫颈癌(CC)是全球范围内普遍存在的妇科癌症,严重影响女性的生活质量和身心健康。然而,利用孟德尔随机化(MR)分析来研究免疫细胞与CC之间的联系的研究有限.本研究旨在探讨免疫性状对子宫颈CC和非肿瘤性疾病的因果影响。从FinnGen数据库下载了731种免疫表型的GWAS数据和6种CC的GWAS数据。随后,使用MREgger进行了两个样本的MR分析,加权中位数,反向方差加权(IVW),简单模式,和加权模式方法。我们的研究已经确定了免疫性状对子宫颈炎性疾病的潜在因果效应,子宫颈的其他非炎症性疾病,宫颈原位癌,子宫颈腺癌,鳞状细胞肿瘤和宫颈癌,以及子宫颈恶性肿瘤,分别为8、6、11、8、23和12。揭示了经典单核细胞与各种宫颈疾病之间的强相关性。此外,我们发现表达BAFF-R的B细胞具有阻止恶性CC进展的能力,特别是鳞状细胞肿瘤和宫颈癌。我们的研究表明,通过两个样本孟德尔随机化,免疫特征与子宫颈CC和非肿瘤性疾病之间存在显着关联。为未来的临床研究提供有价值的见解。
    Cervical cancer (CC) is a prevalent gynecological cancer worldwide that significantly impacts the quality of life and the physical and mental well-being of women. However, there have been limited studies utilizing Mendelian randomization (MR) analysis to investigate the connection between immune cells and CC. This study is to investigate the causal effects of immune traits on CC and non-neoplastic conditions of the cervix. The GWAS data for 731 immunophenotypes and six GWAS data for CC from the FinnGen database were downloaded. Subsequently, a two-sample MR analysis was conducted using the MR Egger, Weighted median, Inverse variance weighted (IVW), Simple mode, and Weighted mode methods. Our study has identified the potential causal effects of immune traits on inflammatory diseases of the cervix, other noninflammatory disorders of the cervix uteri, carcinoma in situ of cervix uteri, adenocarcinomas of cervix, squamous cell neoplasms and carcinoma of cervix, as well as malignant neoplasm of the cervix uteri, with the respective numbers being 8, 6, 11, 8, 23, and 12, respectively. A strong correlation between classic monocytes and various cervical diseases was revealed. Furthermore, we discovered that B cells expressing BAFF-R have the ability to impede the advancement of malignant CC, specifically squamous cell neoplasms and carcinoma of cervix. Our study has demonstrated a significant association between immune traits and both CC and non-neoplastic conditions of the cervix through two-sample Mendelian randomization, providing valuable insights for future clinical research.
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  • 文章类型: Journal Article
    目的:区分普通型宫颈腺癌(UEA)和原发性卵巢肿瘤的卵巢转移通常具有挑战性,因为有几个重叠的特征。本研究旨在探讨转移性卵巢UEA患者的临床病理特征和预后。
    方法:收集了8例转移性卵巢UEA患者的临床病理信息。还进行了免疫染色。
    结果:大多数患者表现为疑似原发性卵巢肿瘤的附件肿块。所有检查的病例在成对的原发性和转移性肿瘤中均显示p16阳性。5例完成术后化疗或同步放化疗(CCRT)的患者没有复发。相比之下,1例在第一个CCRT周期后拒绝进一步治疗的患者出现卵巢和腹膜转移.一名孤立的卵巢转移患者未接受治疗,并在随访期间发生腹膜转移。
    结论:接受卵巢转移治疗的UEA患者显示出良好的预后。鉴于卵巢转移性UEA可以模拟原发性卵巢交界性肿瘤或粘液性或子宫内膜样型癌,病理学家应该意识到这种不寻常但独特的形态,以避免误诊和不当治疗。
    OBJECTIVE: Distinguishing ovarian metastasis of usual-type endocervical adenocarcinoma (UEA) from primary ovarian tumors is often challenging because of several overlapping features. This study aimed to investigate the clinicopathological characteristics and outcomes of patients with metastatic ovarian UEA.
    METHODS: Clinicopathological information was collected from eight patients with metastatic ovarian UEA. Immunostaining was also performed.
    RESULTS: Most patients presented with adnexal masses that were suspected to be primary ovarian tumors. All examined cases showed block p16 positivity in paired primary and metastatic tumors. Five patients who completed post-operative chemotherapy or concurrent chemoradiotherapy (CCRT) did not experience recurrence. In contrast, one patient who refused further treatment after the first CCRT cycle experienced ovarian and peritoneal metastases. One patient with isolated ovarian metastasis left untreated and developed peritoneal metastasis during follow-up.
    CONCLUSIONS: Patients with UEA who received proper management for ovarian metastases showed favorable outcomes. Given that ovarian metastatic UEA can mimic primary ovarian borderline tumor or carcinoma of the mucinous or endometrioid type, pathologists should be aware of this unusual but distinctive morphology to avoid misdiagnosis and inappropriate treatment.
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  • 文章类型: Journal Article
    随着资助者在卡塔赫纳开会,目的是缩小筛查差距,宫颈癌的斗争势头强劲。获得疫苗和治疗。
    Cervical cancer fight gains momentum as funders meet in Cartagena with the aim of closing gaps in screening, access to vaccines and treatment.
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  • 文章类型: Letter
    暂无摘要。
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