- Epidemiologic associations of HPV-positive oropharyngeal cancer and (pre)cancerous cervical lesions. [Journal Article]
- IJInt J Cancer 2018 Feb 14
- CONCLUSIONS: A continuous increase in the HPV-attributable fraction of OPSCC was demonstrated in the period 2000- 2015 in the Amsterdam region. HPV-positive OPSCC has a significant association with a history of suspicious Pap results of the cervix in women. This article is protected by copyright. All rights reserved.
- Folate deficiency and aberrant DNA methylation and expression of FHIT gene were associated with cervical pathogenesis. [Journal Article]
- OLOncol Lett 2018; 15(2):1963-1972
- Aberrant DNA methylation is a recognized feature in various types of human cancer, and folate has a vital role in the epigenetics of mammalian cells by supplying methyl groups for DNA methylation rea...
Aberrant DNA methylation is a recognized feature in various types of human cancer, and folate has a vital role in the epigenetics of mammalian cells by supplying methyl groups for DNA methylation reactions. Fragile histidine triad (FHIT) is a tumor suppressor gene that is frequently silenced in cervical cancer (CC) and preneoplastic lesions. Promoter hypermethylation was previously observed in CC, and its epigenetic silencing has been observed at mRNA or protein levels. Changes in folate intake to modulate DNA methylation may be a mechanistic link to cancer, but this remains to be elucidated. The aim of the present study was to evaluate the influences of folate on FHIT gene methylation and expression in the progression of cervical cancerization. In the present study, red blood cell (RBC) folate levels, FHIT gene methylation status, and mRNA and protein expression levels were detected in 254 women, including normal cervix (NC, n=80), cervical intraepithelial neoplasm grade 1 (CIN1, n=55; CIN2/3, n=55) and cervical squamous cell carcinoma (SCC, n=64) samples. The methylation status of FHIT gene and its mRNA and protein expression levels were measured in CaSki (HPV16 positive) and C33A (HPV16 negative) CC cells treated with different concentrations of folate. The results indicated that FHIT gene methylation rate increased with the severity of cervix lesions, however, RBC folate levels, FHIT mRNA and protein expression levels were reduced. The proliferation inhibition rate, apoptosis rate, and FHIT protein and mRNA expression levels increased along with rising concentrations of folate, whereas the degree of FHIT gene methylation gradually weakened in CaSki or C33A cell lines. The present findings indicated that folate deficiency, FHIT gene promoter hypermethylation and reduced expression were significantly associated with cervical carcinogenesis. The results indicated that folate was able to enhance apoptosis and inhibit the cervical cell proliferation while regulating FHIT gene methylation and expression. Adequate intake of folate to maintain normal DNA methylation status is an effective way for cervical lesions prevention, and demethylation treatment may offer a new strategy for therapy of CC.
- Management of cervical premalignant lesions. [Review]
- CPCurr Probl Cancer 2018 Jan 11
- Treatment of cervical premalignant lesions (cervical intraepithelial neoplasia; CIN) of different grades is very effective, simple, and safe. The entire transformation zone of the cervix needs to be ...
Treatment of cervical premalignant lesions (cervical intraepithelial neoplasia; CIN) of different grades is very effective, simple, and safe. The entire transformation zone of the cervix needs to be treated either by an ablative technique (cryotherapy or thermal ablation) or an excisional technique (large loop excision of transformation zone or cold knife conization); the choice of treatment depends on the size and location of the lesion and the type of the transformation zone. The cure rate after ablative treatment of high-grade CIN may be little lower than that after excisional treatment. The simplicity of the technique, low complication rate, and lesser cost make ablative technique the treatment of choice in the low resourced settings for the eligible lesions. In situations where organizing colposcopy and histopathology services is challenging, simple algorithms like screening with visual inspection with acetic acid test and immediate ablative treatment of the visual inspection with acetic acid-positive women has been recommended by the World Health Organization. Such a strategy is effective in preventing subsequent development of high-grade CIN and also ensures high compliance of the screen positive women to treatment.
- Prevalence of Specific Types of Human Papiloma Virus in Cervical Intraepithelial Lesions and Cervical Cancer in Macedonian Women. [Journal Article]
- MAMed Arch 2018; 72(1):26-30
- CONCLUSIONS: Among Macedonian women, HPV 16, 31 and 18 were HPV types strongly associated with intraepithelial cervical lesions and cervical cancers. The prevalence of high risk HPV was highest in youngest women, but the risk was highest among patients with invasive cervical cancer (ICC). Surprisingly, patients with mixed infection had more LSIL and HSIL then CIS.
- Urine test for HPV genotypes as a predictor of precancerous cervical lesions and for cervical cancer screening. [Journal Article]
- IJInt J Gynaecol Obstet 2018 Jan 31
- CONCLUSIONS: There was good agreement between a positive urine test for high-risk HPV DNA genotypes and pathologic findings of CIN2/3.
- Significance of DNA Replication Licensing Proteins (MCM2, MCM5 and CDC6), p16 and p63 as Markers of Premalignant Lesions of the Uterine Cervix: Its Usefulness to Predict Malignant Potential [Journal Article]
- APAsian Pac J Cancer Prev 2018 01 27; 19(1):141-148
- CONCLUSIONS: MCMs and CDC6 can be applied as biomarkers to predict malignant potential of low grade lesions identified in screening programmes and retesting / follow up might be confined to those with high risk lesions alone so that overuse of resources can be safely avoided.
- Do fertile women have an inferior treatment for high-grade precancerous lesions? [Journal Article]
- JOJ Obstet Gynaecol Res 2018 Jan 25
- CONCLUSIONS: Pregnancy possibility in the future may affect the extent of LLETZ, as assessed by the largest transverse diameter obtained. This finding may be associated with increased resection margin involvement in women with future pregnancy possibility.
- Effect of Dialyzable Leukocyte Extract on chronic cervicitis in patients with HPV infection. [Journal Article]
- JMJ Med Life 2017 Oct-Dec; 10(4):237-243
- The objective of the study was to assess the clinical, histopathological and immunochemical changes induced by dialyzable leukocyte extract (DLE) treatment in patients with chronic cervicitis associa...
The objective of the study was to assess the clinical, histopathological and immunochemical changes induced by dialyzable leukocyte extract (DLE) treatment in patients with chronic cervicitis associated to HPV infection. Fifty-four female Mexican patients diagnosed with chronic cervicitis, cervical intra-epithelial neoplasia grade 1 (CIN 1) and HPV infection were divided into two groups: patients treated with placebo and patients treated with DLE. Clinical and colposcopy evaluations were performed before and after treatments. Cervix biopsies were obtained to analyze histopathological features and to determine the local immunological changes by immunohistochemistry analyses. Placebo-treated patients showed no significant changes in the evaluated parameters. Interestingly, in DLE-treated patients, clinical manifestations of cervicitis diminished and 89% of them remitted the colposcopic lesions. Histological analyses of biopsies from DLE-treated patients showed a decreasing leukocyte infiltrate. Immunochemical analyses showed an increased expression of TGF-β, while expression of IFN-γ, PCNA, and IL-32 decreased. Our results suggest that DLE can stimulate innate immunity of cervical mucosae, diminishing chronic cervicitis in HPV-infected patients.
- Presence of histopathological premalignant lesions and infection caused by high-risk genotypes of human papillomavirus in patients with suspicious cytological and colposcopy results: A prospective study. [Journal Article]
- VPVojnosanit Pregl 2017; 74(1):24-30
- CONCLUSIONS: Patients with suspicious Papanicolaou test, colposcopy results and infection which is caused by high-risk HPV infection (HPV 16 in particular) often have premalignant cervical lesions. In these cases, histopathological confirmation of lesions is mandatory, since it serves as a definitive diagnostic procedure.
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- HPV RNA Test for Cervical Cancer [BOOK]
- BOOKKnowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH): Oslo, Norway
- BackgroundCervical cancer is the second most common cancer in women world-wide and affects about 300 women in Norway each year. Cervical cancer develops through cellular abnormalities...
BackgroundCervical cancer is the second most common cancer in women world-wide and affects about 300 women in Norway each year. Cervical cancer develops through cellular abnormalities in the cervix that can be detected by cytological tests. With the introduction of organized cervical cytologic screening programs, the incidence of cervical cancer has been dramatically reduced. However, cytologic screening tests also have limitations, especially their limited sensitivity. Because infection with oncogenic human papillomavirus (HPV) has been identified as the underlying cause of cervical cancer, there is interest in the use of HPV testing as a screening test for cervical cancer. The overall prevalence of HPV among cervical cancers is more than 99%. We have evaluated HPV RNA testing for cervical pre cancer lesions by assessing the diagnostic accuracy of the HPV RNA tests compared with cytology and HPV DNA testing.MethodsWe have systematically searched the following databases for studies that fulfilled our criteria:Medline (Ovid) 1966 – 2007, September week 1. Embase (Ovid) 1980 – 2007 week 37. CRD databases (DARE, NHS EED, HTA) 2007, September. Relevant topics and text words were combined. We also composed a search filter for diagnostic studies. NorChip AS who has developed a HPV mRNA test was invited to dispatch documentation. We included published literature based on the following criteria:Population:WomenIndex test:HPV RNA testsComparators:HPV DNA tests or cytology for screening of cervical cancerReference standard:HistologyStudy design:No limitOutcome:Test sensitivity and specificity, positive and negative predictive value or other values that describe diagnostic accuracy Development of cancer Test reliabilityLanguage:English and Scandinavian We did not include publications from conferences or abstracts. Relevance and quality was assessed according to our handbook. We used GRADE to assess the documentation for diagnostic accuracy. The results are presented in tables and in a descriptive summary. This work has been carried out by two researchers at NOKC and the report has been externally reviewed. We calculated diagnostic accuracy using 2 x 2 tables for each study.ResultsWe identified 2498 references and assessed 31 full-text articles. Five studies were included in the report and results were extracted and pooled from three of them. Details of each study are presented in evidence tables. Two of the studies were sponsored by the producers of the tests. We have assessed the quality of the documentation of diagnostic accuracy using GRADE. For HPV RNA testing, the quality is very low which means that the results are very uncertain. It is not known whether HPV RNA testing give a better diagnostic accuracy than HPV DNA testing and cytology. In summary these results showed:The HPV RNA tests had slightly lower sensitivity compared with HPV DNA tests (77 % (95 % CI 73-81) versus 92 % (95 % CI 89-94), while cytology had lowest sensitivity (61 %). The sensitivity states the probability of a positive test result if you have the disease. The HPV RNA tests had slightly higher specificity compared with HPV DNA tests (64 % (95 % CI 60-68) versus 45 % (95 % CI 41-49)), while cytology had highest specificity (81 %). The specificity states the probability of a negative test result if you are healthy. The HPV RNA tests had comparable positive predictive value with the HPV DNA tests (63 % (95 % CI 59-67) versus 57 % (95 % CI 53-60), while cytology had the highest positive predictive value (91 %). Positive predictive value states the probability of illness among people with a positive test. The HPV RNA tests had slightly lower negative predictive value compared with the HPV DNA tests (78 % (95 % CI 74-82) versus 87 % (95 % CI 83-91)), while cytology had the lowest negative predictive value (39 %). Negative predictive value states the probability of illness among people with a negative test.ConclusionsDue to spare and low quality documentation, we do not know if HPV RNA tests have a better diagnostic accuracy compared to HPV DNA tests and cytology for detection of cervical pre cancer lesions. Norwegian Knowledge Centre for the Health Services summarizes and disseminates evidence concerning the effect of treatments, methods, and interventions in health services, in addition to monitoring health service quality. Our goal is to support good decision making in order to provide patients in Norway with the best possible care. The Centre is organized under The Directorate for Health and Social Affairs, but is scientifically and professionally independent. The Centre has no authority to develop health policy or responsibility to implement policies.