human papillomavirus viruses

人乳头瘤病毒
  • 文章类型: Journal Article
    目的:在本研究中,我们的目的是验证PAX1和JAM3甲基化(PAX1m/JAM3m)检测在非16/18高危人类乳头瘤病毒阳性患者(非16/18hrHPV+)中作为检测宫颈上皮内瘤变3级或更高级别(CIN3+)的分诊工具的性能.
    方法:比较了液基细胞学(LBC)和PAX1m/JAM3m试验检测CIN3的分诊性能。
    结果:总计,1851名参与者有宫颈组织学结局,并纳入分析。LBC检测结果对意义不明确或更差的非典型鳞状细胞(LBC≥ASCUS)和PAX1m/JAM3m检测的敏感性/特异性分别为90.1%/26.7%和84.8%/88.5%,分别。PAX1m/JAM3m(+)在整个队列中具有最高的诊断AUC(0.866,95%置信区间(CI)0.837-0.896)。所有癌症(n=20)均通过PAX1m/JAM3m(+)检测。与LBC≥ASCUS相比,PAX1m/JAM3m()使需要转诊进行阴道镜检查的患者人数减少了57.21%(74.66%vs.17.45%)。LBC≥ASCUS和PAX1m/JAM3m(+)检测CIN3+的比值比为3.3(95%CI2.0-5.9)和42.6(27.1-69.6),分别(p<0.001)。LBC≥ASCUS或PAX1m/JAM3m(+)的组合略微增加了诊断灵敏度(98.0%,95%CI:95.8-100%)和转诊率(77.09%),但降低了诊断特异性(24.8%,22.7-26.8%)。
    结论:在非16/18hrHPV(+)女性中,PAX1m/JAM3m检测CIN3+优于细胞学。与LBC≥ASCUS相比,PAX1m/JAM3m(+)减少了转诊至阴道镜的显著次数而不影响诊断灵敏度。
    OBJECTIVE: In this study, we aimed to validate the performance of the PAX1 and JAM3 methylation (PAX1m/JAM3m) test as a triage tool for detecting cervical intraepithelial neoplasia grade 3 or worse (CIN3 +) in non-16/18 high-risk human papillomavirus-positive patients (non-16/18 hrHPV +).
    METHODS: The triage performance of liquid-based cytology (LBC) and the PAX1m/JAM3m test for detecting CIN3 + were compared.
    RESULTS: In total, 1851 participants had cervical histological outcomes and were included in the analysis. The sensitivity/specificity of the LBC test results with atypical squamous cells of undetermined significance or worse (LBC ≥ ASCUS) and the PAX1m/JAM3m test were 90.1%/26.7% and 84.8%/88.5%, respectively. PAX1m/JAM3m( +) had the highest diagnostic AUC (0.866, 95% confidence interval (CI) 0.837-0.896) in the whole cohort. All cancers (n = 20) were detected by PAX1m/JAM3m(+). Compared with LBC ≥ ASCUS, PAX1m/JAM3m(+) reduced the number of patients who needed referral for colposcopy by 57.21% (74.66% vs. 17.45%). The odds ratios for detecting CIN3 + by LBC ≥ ASCUS and PAX1m/JAM3m(+) were 3.3 (95% CI 2.0-5.9) and 42.6 (27.1-69.6), respectively (p < 0.001). The combination of LBC ≥ ASCUS or PAX1m/JAM3m(+) slightly increased the diagnostic sensitivity (98.0%, 95% CI: 95.8-100%) and referral rate (77.09%) but reduced the diagnostic specificity (24.8%, 22.7-26.8%).
    CONCLUSIONS: In non-16/18 hrHPV(+) women, PAX1m/JAM3m was superior to cytology for detecting CIN3 + . Compared with LBC ≥ ASCUS, PAX1m/JAM3m(+) reduced the number of significant referrals to colposcopy without compromising diagnostic sensitivity.
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  • 文章类型: Journal Article
    持续的人乳头瘤病毒(HPV)感染仍然是宫颈癌的关键危险因素。基于HPV的初筛在临床指南中被广泛推荐,与细胞学相比,需要进一步的纵向研究来优化检测高级别宫颈病变的策略。
    从2015年11月到2023年12月,31,942名参与者被纳入现实世界的观察研究。其中,4,219名参与者接受了至少两轮HPV测试,397人完成了三轮HPV检测。所有参与者均接受了高危型HPV16/18/31/33/35/39/45/51/52/56/58/59/66/68(hrHPV)和低危型HPV6/11基因分型检测。一些参与者还接受了细胞学检查或阴道镜检查。
    在横截面队列中,hrHPV和所有HPV亚型的患病率分别为6.6%(2,108/31,942)和6.8%(2,177/31,942),分别。前三个hrHPV基因型是HPV52(1.9%),HPV58(0.9%),和HPV16(0.9%)。年龄分布在45-49岁和60-65岁出现两个高峰。对于初级筛查队列,hrHPV患病率从2015-2017年的4.8%上升至2020年的7.0%,最终在2023年达到7.2%.对于纵向队列研究,重复人群中的hrHPV患病率(3.9、5.3和6.0%)低于初次hrHPV筛查率(6.6%),这表明重复筛查可能会降低患病率。方法上,hrHPV(89.5%)和16种亚型筛查组(92.3%)的敏感性优于细胞学组(54.4%).此外,纵向研究表明,持续性hrHPV亚组的高级别鳞状上皮内病变和更多组织学进展事件的发生率明显更高(p=0.04)(7/17vs.0/5)比再感染组。
    这项研究表明,东莞的高危型HPV患病率正在上升,反复筛查减少了这种趋势。研究结果支持基于HPV的初筛,并可能指导华南地区的HPV疫苗接种和宫颈癌预防。
    UNASSIGNED: Persistent human papillomavirus (HPV) infection remains a key risk factor for cervical cancer. HPV-based primary screening is widely recommended in clinical guidelines, and further longitudinal studies are needed to optimize strategies for detecting high-grade cervical lesions compared to cytology.
    UNASSIGNED: From November 2015 to December 2023, 31,942 participants were included in the real-world observational study. Among those, 4,219 participants underwent at least two rounds of HPV tests, and 397 completed three rounds of HPV tests. All participants were tested for high-risk types of HPV 16/18/31/33/35/39/45/51/52/56/58/59/66/68 (hrHPV) and low-risk types of HPV6/11 genotyping. Some participants also received cytology or colposcopy with pathology.
    UNASSIGNED: In the cross-sectional cohort, the prevalence of hrHPV and all HPV subtypes was 6.6% (2,108/31,942) and 6.8% (2,177/31,942), respectively. The three top hrHPV genotypes were HPV52 (1.9%), HPV58 (0.9%), and HPV16 (0.9%). Age distributions showed two peaks at 45-49 and 60-65 years. For the primary screening cohort, the hrHPV prevalence rate increased from 4.8% in 2015-2017 to 7.0% in 2020-2020 and finally reached 7.2% in 2023. For the longitudinal cohort study, the hrHPV prevalence rates in the repeated population (3.9, 5.3, and 6.0%) were lower than the primary hrHPV screening rates (6.6%), which indicated that repeated screening might decrease the prevalence rate. Methodologically, the hrHPV (89.5%) and the screening group of 16 subtypes (92.3%) demonstrated superior sensitivity than the cytology group (54.4%). Moreover, the longitudinal study indicated that the persistent hrHPV subgroup had a significantly higher (p = 0.04) incidence of high-grade squamous intraepithelial lesions and more histology progression events (7/17 vs. 0/5) than the reinfection group.
    UNASSIGNED: The study indicates a rising high-risk HPV prevalence in Dongguan, with repeated screening reducing this trend. The findings support HPV-based primary screening and might guide HPV vaccination and cervical cancer prevention in South China.
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  • 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
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  • 文章类型: Journal Article
    宫颈癌在中国仍然是一个巨大的健康负担,其特点是发病率和死亡率高,低人类乳头瘤病毒(HPV)疫苗接种覆盖率加剧了这种情况,导致生产力的大幅损失,情感上的痛苦,和家庭紧张。了解影响HPV意识和知识的因素对于制定有效的教育策略至关重要。这项横断面研究,于2022年9月至10月进行,涉及来自江苏省各教育机构的2679名大学生,中国。数据是通过涵盖人口统计的在线问卷收集的,HPV知识,和疫苗接种行为。统计分析,包括卡方检验和多因素Logistic回归,用于确定影响HPV知识的因素。研究表明,虽然超过90%的学生正确识别了HPV的传播和风险,重大的知识差距和误解仍然存在,特别是关于HPV与HIV/AIDS的关联及其治疗。与更好的HPV知识显著相关的因素包括年龄(22-24岁),女性性别,作为一个医学专业,在一段关系中,熟悉HPV,参与性教育项目。尽管接受HPV疫苗的意愿很高(91.64%),实际疫苗接种率仍然很低。这些发现表明,虽然中国大学生普遍意识到HPV,有针对性的教育干预对于解决知识差距和有效促进HPV疫苗接种至关重要.
    Cervical cancer remains a significant health burden in China, characterized by high incidence and mortality rates, which are exacerbated by low Human Papillomavirus (HPV) vaccination coverage, leading to substantial loss of productivity, emotional suffering, and family strain. Understanding factors that influence HPV awareness and knowledge is crucial for developing effective educational strategies. This cross-sectional study, conducted from September to October 2022, involved 2,679 college students from various educational institutions in Jiangsu Province, China. Data were collected via an online questionnaire covering demographics, HPV knowledge, and vaccination behaviors. Statistical analyses, including Chi-square tests and multifactorial logistic regression, were used to identify factors influencing HPV knowledge. The study revealed that while over 90% of students correctly identified HPV\'s transmission and risks, significant knowledge gaps and misconceptions persist, particularly regarding HPV\'s association with HIV/AIDS and its treatment. Factors significantly associated with better HPV knowledge included age (22-24 years), female gender, being a medical major, being in a relationship, familiarity with HPV, and participation in sexual education programs. Despite a high willingness to receive the HPV vaccine (91.64%), actual vaccination rates remained low. These findings suggest that while Chinese college students were generally aware of HPV, targeted educational interventions are essential to address knowledge gaps and promote HPV vaccination effectively.
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  • 文章类型: Journal Article
    目的:鉴于人类乳头状瘤病毒感染(HPV)在预后过程中的影响以及对口腔鳞状细胞癌(OSCC)患者的治疗方法的影响,我们试图研究P16表达对OSCC和并发感染患者的临床病程和病理表现的影响.
    方法:使用S-P免疫组织化学,我们检测了460例OSCC患者中P16和Ki67的表达。我们比较了同一患者肿瘤细胞和正常上皮粘膜之间蛋白质的表达。临床和病理特征(包括性别、年龄,组织学分级,淋巴结转移,临床分期,临床复发,肿瘤直径,Ki67增殖指数)进行分层统计学分析。
    结果:共发现460例OSCC,与正常粘膜上皮组相比,OSCC组P16的表达明显更高(X2=60.545,p=.000)。似乎也有性别倾向,因为女性的表达高于男性(0.218vs.0.144,X2=3.921,p=.048)。年轻的年龄似乎也是一个预测因素,因为35岁以下的人与35岁以上的人相比,该蛋白的表达更高(0.294vs.0.157,X2=4.230,p=.040)。P16阳性与组织学分级呈显著正相关(X2=4.114,p=.043)。此外,在ki67患者中,P16的阳性率高于85%(0.455vs.0.160,X2=6.667,p=0.023)。
    结论:OSCC合并HPV感染倾向于在女性患者和35岁以下患者中更频繁发生。P16和ki67蛋白表达的HPV感染可能以更高的频率促进OSCC的增殖和生长。
    OBJECTIVE: Given the implications of concurrent human papilloma viral infection (HPV) in the prognostic course and implications on therapeutic approached of patients with oral squamous cell carcinoma (OSCC), we seek to investigate the implications that P16 expression has on the clinical course and pathological appearance of patients with OSCC and concurrent infection.
    METHODS: Using S-P immunohistochemistry, we examined the expression of P16 and Ki67 in 460 patients with OSCC. We compared the expression of the protein between the tumor cells and normal epithelial mucosa within the same patient. The clinical and pathological characteristics (including gender, age, histological grade, lymph node metastasis, clinical stage, clinical recurrence, tumor diameter, Ki67 proliferation index) were analyzed by stratification statistically.
    RESULTS: In total 460 cases of OSCC were identified and expression of P16 was significantly higher in the OSCC group compared to the normal mucosal epithelial group (X2 = 60.545, p = .000). There also appear to be a gender predilection as the expression was higher in females compared to males (0.218 vs. 0.144, X2 = 3.921, p = .048). Younger age also appears to be a predictive factor as those under 35 years old had higher expression of the protein compared to those over 35 years old (0.294 vs. 0.157, X2 = 4.230, p = .040). P16 positivity showed a significant positive correlation with histologic grade (X2 = 4.114, p = .043). In addition, the positive rate of P16 was higher in patients with ki67 over 85% (0.455 vs. 0.160, X2 = 6.667, p = .023).
    CONCLUSIONS: OSCC with HPV infection tends to occur more frequently in female patients and those under 35 years of age. HPV infection with expression of the P16 and ki67 protein may promote the proliferation and growth of OSCC at a higher frequency.
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