human papillomavirus (hpv)

人乳头瘤病毒 (HPV)
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    口咽人乳头瘤病毒(HPV)癌症很普遍,但在牙科诊所的HPV教育并不常见.这项研究的目的是评估牙科提供者和患者的知识,态度,以及对HPV教育的偏好,然后评估对现有HPV教育材料的看法,以便在牙科就诊时使用。阿巴拉契亚俄亥俄州牙科患者(n=13)和普通/儿科牙科提供者(n=10)完成了初始,关于当前HPV知识和HPV教育态度的近距离调查,参与,和资源偏好。通过虚拟焦点小组(n=9)或独立审查调查(n=6)选择个人审查现有的HPV教育视频和工具包。使用讨论指南,参与者总体上做出了回应,视觉,听觉,和内容满意度声明,口头(焦点小组)或使用李克特量表(独立评论)。以频率/百分比对调查进行了总结;对转录本进行了定性编码,以确定潜在的材料修饰。牙科提供者和患者对HPV和口腔癌教育更满意(87%和96%,分别)和筛查(96%),而在牙科就诊期间接受HPV疫苗教育(74%)和转诊(61%)。提供者既没有分享HPV教育材料(80%),也没有与牙科患者进行教育对话(100%)。美国癌症协会的视频和“Maureen团队”工具包是最受欢迎的资源(即,所有参与者组的负面/不一致陈述较少)。研究结果表明,未来的牙科HPV教育工作应通过目前可用的材料来了解。需要额外的干预措施来促进牙科提供者的讨论和与患者分享教育材料,以增加HPV疫苗的教育和推广,并减少口咽癌症。
    Oropharyngeal human papillomavirus (HPV) cancers are prevalent, but HPV education in dental clinics is uncommon. The purpose of this study was to evaluate dental provider and patient knowledge from, attitudes towards, and preferences for HPV education, then assess perceptions of existing HPV educational materials for use at dental visits. Appalachian Ohio dental patients (n = 13) and general/pediatric dental providers (n = 10) completed an initial, close-ended survey on current HPV knowledge and HPV educational attitudes, participation, and resource preferences. Select individuals reviewed existing HPV educational videos and toolkits via virtual focus groups (n = 9) or independent review surveys (n = 6). Using a discussion guide, participants responded to overall, visual, auditory, and content satisfaction statements, orally (focus groups) or with Likert scales (independent reviews). Surveys were summarized with frequencies/percentages; transcripts were qualitatively coded to identify potential material modifications. Dental providers and patients were more comfortable with HPV and oral cancer education (87% and 96%, respectively) and screening (96%) than with HPV vaccine education (74%) and referrals (61%) during dental visits. Providers were neither sharing HPV educational materials (80%) nor initiating educational conversations with dental patients (100%). The American Cancer Society videos and the \"Team Maureen\" toolkit were the most liked resources (i.e., fewer negative/disagree statements) by all participant groups. Findings indicate that future dental HPV educational efforts should be informed by currently available materials. Additional interventions are needed to promote dental provider discussions and sharing of educational materials with patients to increase education and promotion of the HPV vaccine and reduce oropharyngeal cancers.
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  • 文章类型: Editorial
    墨西哥的国家人乳头瘤病毒(HPV)疫苗接种计划成立于2008年,免费提供HPV疫苗,并迅速成为一个巨大的成功故事,在墨西哥年轻女性中实现显著覆盖。然而,尽管做出了这些努力和显著成就,在15岁或以上的墨西哥女性中,主要由HPV引起的宫颈癌仍然是一个具有挑战性的问题。该国妇女面临的一个关键障碍是缺乏早期检测和筛查资源,加上诊断和治疗的延误,由于本已不足的医疗资源分配不畅而加剧。这种情况为该国的女性人口创造了不利的条件。我们的社论旨在提请注意迫切需要改善获得适当预防的机会,筛选,以及在墨西哥对宫颈癌患者的治疗,倡导墨西哥政府之间的集体努力,公共卫生专业人员,和民间社会。
    Mexico\'s national human papillomavirus (HPV) vaccination program was established in 2008, providing free access to HPV vaccines and quickly becoming an immense success story, achieving significant coverage among young Mexican females. However, despite these efforts and notable achievements, cervical cancer caused mainly by HPV remains a challenging issue among Mexican women aged 15 years or older. A critical obstacle faced by women in the country is a lack of early detection and screening resources, coupled with delays in diagnosis and treatment, exacerbated by the poor distribution of already insufficient healthcare resources. This situation creates adverse conditions for the female demographic in the country. Our editorial aims to draw attention to the urgent need to improve access to adequate prevention, screening, and treatment for cervical cancer patients in Mexico, advocating for a collective effort between the Mexican government, public health professionals, and civil society.
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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
    人乳头瘤病毒(HPV)与各种癌症有关,包括那些影响皮肤的。这项研究评估了台湾地区与HPV感染相关的皮肤癌的长期风险,使用2007年至2015年国家健康保险研究数据库的数据。我们的分析显示,HPV患者患皮肤癌的风险显着增加,特别是对于鳞状细胞癌(SCC),观察到的校正风险比(aHR)最高的亚型=5.97,95%CI:4.96-7.19).HPV相关皮肤癌的总体aHR为5.22(95%CI:4.70-5.80),表明HPV阳性组的风险明显更高。皮肤癌的风险进一步按类型分层,基底细胞癌(aHR=4.88,95%CI:4.14-5.74),和黑色素瘤(aHR=4.36,95%CI:2.76-6.89)也显示与HPV显著相关。该研究还强调了区域差异,台湾南部和高雄-屏东地区的风险增加。主要发现强调了防晒的重要性,特别是在高紫外线暴露地区和高风险职业的个人中。这项研究有助于更好地理解HPV和皮肤癌风险之间的复杂相互作用。加强预防策略在公共卫生中的重要性。
    Human papillomavirus (HPV) has been implicated in various cancers, including those affecting the skin. The study assessed the long-term risk of skin cancer associated with HPV infection in Taiwan region, using data from the National Health Insurance Research Database between 2007 and 2015. Our analysis revealed a significant increase in skin cancer risk among those with HPV, particularly for squamous cell carcinoma (SCC), the subtype with the highest observed adjusted hazard ratio (aHR) = 5.97, 95% CI: 4.96-7.19). The overall aHR for HPV-related skin cancer was 5.22 (95% CI: 4.70-5.80), indicating a notably higher risk in the HPV-positive group. The risk of skin cancer was further stratified by type, with basal cell carcinoma (aHR = 4.88, 95% CI: 4.14-5.74), and melanoma (aHR = 4.36, 95% CI: 2.76-6.89) also showing significant associations with HPV. The study also highlighted regional variations, with increased risks in southern Taiwan and the Kaohsiung-Pingtung area. Key findings emphasize the importance of sun protection, particularly in regions of high UV exposure and among individuals in high-risk occupations. This research contributes to a better understanding of the complex interactions between HPV and skin cancer risk, reinforcing the importance of preventive strategies in public health.
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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
    背景:法国在欧洲的口咽癌(OPC)发病率排名第六,但高危型HPV(HR-HPV)的流行病学影响仍未得到充分记录.我们研究的目的是评估巴黎HR-HPV引起的OPCs比例,和它的郊区,在过去的四十年里。该地区几乎占法国总人口的五分之一。
    方法:在巴黎及其郊区的两个主要的HNC转诊癌症中心于1981年、1986年、1991年、1996年、2001年、2006年、2011年、2016年和2020年/2021年诊断的OPCs从肿瘤生物库中检索。通过p16染色和HPV-DNA检测确定HPV状态。如果两个测定都是阳性的,则认为样品是HPV驱动的。将结果与法国癌症登记数据进行比较。
    结果:评估了697名OPC患者的样本(包括2001年,2006年,2011年,2016年,2021年诊断的所有样本的82%)。从1981年到2021年,HPV驱动的病例比例从2.7%上升到53%。HPV16是研究期间的优势基因型。HPV驱动的OPC患者,81%为男性,42%为吸烟者,而HPV阴性者为80%和92%。OPC患者的年龄显著增加,在学习期间,结论:巴黎及其郊区HPV驱动的OPCs比例显著增加,在过去的四十年里。OPCs已成为头颈癌的第二主要类型,在法国。这可能与HPV驱动病例的增加以及男性烟草和酒精消费的减少有关。
    BACKGROUND: France has the sixth highest incidence of oropharyngeal cancer (OPC) in Europe, but the epidemiological impact of high-risk HPV (HR-HPV) remains poorly documented. The objective of our study was to assess the proportion of OPCs caused by HR-HPV in Paris, and its suburbs, over the four past decades. This area accounts for almost one-fifth of the total population of France.
    METHODS: OPCs diagnosed in 1981, 1986, 1991, 1996, 2001, 2006, 2011, 2016 and 2020/2021 in two of the main referral cancer centers for HNCs in Paris and its suburbs were retrieved from the tumor biobanks. HPV status was determined by p16-staining and HPV-DNA detection. Samples were considered HPV-driven if both assays were positive. Results were compared to the French cancer registry data.
    RESULTS: Samples from 697 OPC patients were assessed (including 82 % of all samples diagnosed in 2001, 2006, 2011, 2016, 2021). The proportion of HPV-driven cases rose from 2.7 % to 53 % between 1981 and 2021. HPV16 was the dominant genotype during the study period. Of patients with HPV-driven OPC, 81 % were male and 42 % were smokers versus 80 % and 92 % in their HPV-negative counterparts. The age of OPC patients increased significantly, during the study period, independent of their HPV status CONCLUSION: The proportion of HPV-driven OPCs has significantly increased in Paris and its suburbs, during the last four decades. OPCs has become the 2nd predominant type of head and neck cancer, in France. This may be linked to the rise in HPV-driven cases and the decrease of tobacco and alcohol consumption in men.
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  • 文章类型: Journal Article
    截至2019年,27至45岁的男性有资格接受人乳头瘤病毒(HPV)疫苗接种,但对他们是否已经接受或打算接受疫苗接种知之甚少。我们做了一个横断面,2022年3月至4月在27至45岁的父亲中进行的在线调查,以评估HPV疫苗接种意识之间的关联,行为,意图,和来自健康信念模型的社会心理建构。我们检查了那些听说过HPV疫苗的人的特征,(b)已接受≥1剂,以及(c)从未接种过疫苗的人今后接种疫苗的意向。在完成调查的400名男性中,32%的人不知道HPV疫苗。在那些知道的人中,41%的人接受了≥1次剂量。63%的未接种疫苗的男性报告说他们打算在将来接种疫苗。多变量逻辑回归分析显示,年龄和种族/民族与以前接种过疫苗有关。在未接种疫苗的人群中,多变量逻辑回归分析显示,与那些具有较低的感知风险的人相比,具有较高的HPV相关癌症风险的人有3.73更多的机会报告他们寻求疫苗接种(95%置信区间[CI]=[1.28,12.3])。我们没有发现明显的好处,障碍,或决策自我效能与未来的疫苗意图有关。由于该小组的建议包括共同的临床决策,公共卫生工作应侧重于提高对疫苗合格性的认识,强调HPV相关癌症的危险因素,以便个体对风险有准确的认识,鼓励男人和他们的提供者之间的对话。
    Men aged 27 to 45 are eligible for human papillomavirus (HPV) vaccination as of 2019, yet relatively little is known about whether they have received or intend to receive it. We conducted a cross-sectional, online survey among fathers aged 27 to 45 between March and April 2022, to assess associations between HPV vaccination awareness, behaviors, intentions, and psychosocial constructs from the Health Belief Model. We examined the characteristics of those who had (a) heard of the HPV vaccine, (b) already received ≥ 1 dose, and (c) intentions for future vaccination among those who had never been vaccinated. Among 400 men who completed the survey, 32% were not aware of the HPV vaccine. Among those who were aware, 41% had received ≥ 1 dose. Sixty-three percent of unvaccinated men reported that they intended to get vaccinated in the future. Multivariable logistic regression analyses revealed that age and race/ethnicity were associated with having been vaccinated previously. Among the unvaccinated, multivariable logistic regression analyses revealed that those with a higher perceived risk of HPV-associated cancer had 3.73 greater odds of reporting they would seek vaccination compared to those with lower perceived risk (95% confidence interval [CI] = [1.28, 12.3]). We did not find perceived benefits, barriers, or decision self-efficacy to be related to future vaccine intentions. Since recommendations for this group include shared clinical decision-making, public health efforts should focus on raising awareness of vaccine eligibility, emphasizing risk factors for HPV-associated cancers so that individuals have an accurate perception of risk, and encouraging conversation between men and their providers.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    宫颈癌影响全球女性,是最常见的人乳头瘤病毒(HPV)相关癌症。由于潜在的病毒感染,由HPV引起的癌变导致特定的癌症行为。已经详细阐明了从病毒感染转化为癌细胞的机制和时机。这种癌症的治疗基于其特征并正在实施。此外,HPV感染在世界范围内广泛存在,并通过性活动传播。尽管HPV疫苗接种是预防宫颈癌的最有效策略,为整个人口接种疫苗是不可行的,特别是在低收入和中等收入国家。为了考虑HPV疫苗接种的下一步,我们需要了解HPV癌变和宫颈癌的特点。此外,通常需要针对宫颈癌患者保留生殖功能的治疗,由于子宫颈是生殖器官,并且由于该疾病在青少年和年轻成人一代中更为普遍。因此,诊断仍有许多挑战,治疗,和预防宫颈癌。
    Cervical cancer affects women worldwide and is the most common human papillomavirus (HPV)-associated cancer. Carcinogenesis caused by HPV results in specific cancer behavior because of the underlying viral infection. The mechanism and timing of the transformation from viral infection to cancer cells have been elucidated in detail. Treatments for this cancer are based on its characteristics and are being implemented. Moreover, HPV infection is widespread worldwide and is transmitted through sexual activity. Although the HPV vaccination is the most effective strategy of preventing cervical cancer, it is not feasible to vaccinate the entire human population especially in low- and middle-income countries. In order to consider the next step for HPV vaccination, we need to understand the characteristics of HPV carcinogenesis and cervical cancer. Additionally, treatment aimed at preservation of reproductive function in patients with cervical cancer is often required, as the cervix is a reproductive organ and because the disease is more prevalent in the adolescent and young adult generation. Thus, there are still many challenges in the diagnosis, treatment, and prevention of cervical cancer.
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