Impacts of HIV infection and long-term use of antiretroviral therapy on the prevalence of oral human papilloma virus type 16

J Oral Pathol Med (2012) 41 : 309–314 Background: The objectives of this study were to determine (i) the prevalence and the copy numbers of oral human papilloma virus type 16 (HPV‐16) in HIV‐infected patients compared with non‐HIV controls, and (ii) the effects of antiretroviral therapy (ART) and its duration on the virus. Methods: A cross‐sectional study was carried out in HIV‐infected patients with and without ART and in non‐HIV controls. Saliva samples were collected, and the DNA extracted from those samples was used as a template to detect HPV‐16 E6 and E7 by quantitative polymerase chain reaction. Student’s t‐test and ANOVA test were performed to determine the prevalence rates among groups. Results: Forty‐nine HIV‐infected patients: 37 on ART (age range, 23–54 years; mean, 37 years), 12 not on ART (age range, 20–40 years; mean, 31 years), and 20 non‐HIV controls (age range, 19–53 years; mean, 31 years) were enrolled. The prevalence of oral HPV‐16 infection and the copy numbers of the virus were significantly higher in HIV‐infected patients than in non‐HIV controls when using E6 assay (geometric mean = 10696 vs. 563 copies/10⁵ cells, P < 0.001), but not E7 assay. No significant difference was observed between those who were and were not on ART. Long‐term use of ART did not significantly change the prevalence of oral HPV‐16 infection and the copy numbers of the virus (P = 0.567). Conclusion: We conclude that the prevalence of oral HPV‐16 infection and the copy numbers of the virus are increased by HIV infection. Neither the use of ART nor its duration significantly affected the virus.     

Growth patterns and final height of survivors of childhood leukemia

Growth patterns of 85 survivors of childhood leukemia were analyzed retrospectively. All patients remained in first remission with no central nervous system involvement. The mean age at diagnosis was 5.8 +/- 3.6 years. The diagnoses were acute lymphoblastic leukemia (ALL) in 68 patients (80%) and acute non-lymphoblastic leukemia (ANLL) in 17 patients (20%). All except two patients received cranial irradiation: 51 patients with 1,800 cGy and 32 patients with 2,400 cGy. Mean height SDS was -0.7 +/- 1.36 at the time of diagnosis, which decreased to -0.92 +/- 1.31 by the end of treatment, and further decreased to -1.14 +/- 1.38 at 6 years after cessation of treatment. Mean weight SDS was -0.55 +/- 1.13 at the time of diagnosis, increasing slightly to -0.39 +/- 1.02 at the end of treatment, and decreasing to -0.46 +/- 1.65 at 6 years after cessation of treatment. Of these survivors, 51 patients (26 boys and 25 girls) reached a final height that was 1.04 SDS or 5.3 cm less than their target height. There was no difference of height and weight SDS between patients with ALL and ANLL. Girls and boys had different growth patterns. Girls had a slightly increased height SDS and gained more weight after cessation of treatment, resulting in less final height deficit and overweight for height, whereas boys had further height and weight reduction resulting in more deficit of final height.     

Delay in breast cancer care: a study in Thai women

BACKGROUND: Breast cancer is the second most common cause of cancer death in Thai women. Cancer registry data reveal a high prevalence of late-stage disease at diagnosis. The factors resulting in delay in Thailand have not yet been investigated. OBJECTIVES: To determine the extent of, and the factors contributing to, delay in breast cancer care. DESIGN: Women with breast cancer who were first treated at Songklanagarind Hospital between June 1994 and June 1996 were interviewed with retrospective chart audits of care. MEASURES: Dependent variables included patient delay (symptom recognition to first care) and system delay (first care to treatment). Independent variables tested included demographic factors, help-seeking behavior, and cancer knowledge. Nonparametric rank sum tests were used for univariate analysis, and Cox regression was used for multivariate analysis. RESULTS: Ninety-four cases were included in the study. The median patient and system delays were 4 weeks; 26.6% and 24.4% of patients, respectively, experienced patient and system delay >12 weeks. Only marital status (unmarried compared with married women) was significantly associated with patient delay (hazard ratio [HR] 2.78, 95% CI 1.23-6.25). Contacting a provincial hospital instead of a university hospital as first medical care (hazard ratio 2.50, 1.23-5.26), being given a diagnosis rather than being told nothing (HR 2.04, 1.14-3.57) and being given treatment rather than being immediately referred (HR 4.55, 2.22-9.09) were associated with system delay. CONCLUSIONS: Patient delay and system delay in breast cancer care are important weaknesses of disease control in Thailand. Educational programs should target unmarried women, who are at higher risk of delay. System delay in hospitals outside the university needs to be improved by a good referral system.     

汇合血清样本技术筛查云南血吸虫病的初步研究

目的研究汇合血清样本技术用于筛查云南血吸虫感染人群的稀释极限和最适汇合样本数.方法采用随机抽样法,对云南血吸虫病疫区人群抽样采集血样;将所采集的31份阳性血样和24份阴性血样,分别按阳性和阴性样本汇合比为1：1,1：2,1：3,1：4,1：9和1：14随机汇合,共得到汇合样本372份.用IHA检测抗体法,在稀释度分别为1：5,1：10,1：20,1：40四组中共检测1448份汇合血样,与对单份样本检测的效果进行统计分析和比较.结果在稀释度分别为1：5,1：10,1：20,1：40四组中,稀释度为1：5组IHA检测汇合样本的敏感性显著高于其它稀释度的三组,且敏感性随汇合样本数量的增加而降低.在稀释度为1：5组,当汇合样本数小于6时,IHA的敏感性仍高于90%.结论用IHA检测汇合血清样本以筛查血吸虫感染时,汇合样本的稀释限度为1：5,最适汇合血清样本数不大于6,可避免较少地漏检阳性血样.     

云南地区乙型肝炎病毒基因型分布与临床的相关性

目的: 了解云南地区乙型肝炎病毒基因型分布特征, 探讨其与慢性HBV感染者的性别和年龄、不同临床疾病谱、病毒复制水平的关系.方法:选择云南地区慢性HBV感染者117例, 其中慢性无症状乙型肝炎表面抗原携带者(ASC)26例、慢性乙型肝炎(CHB)55例(轻度21例、中度24例、重度10例)、慢性重型肝炎(CLF)18例、乙肝后肝硬化(LC)11例及原发性肝细胞肝癌(HCC)7例, 采用反向杂交技术(RDB)检测HBV基因型, 并对与其性别年龄、临床分型和病毒复制水平的关系进行分析.结果: 云南地区HBV基因型以B型和C型为主, 分别为41.0%(48/117)和54.7%(64/117) , 并以C型为最多(χ2 = 4.38, P = 0.036);D型1例(0.86%), B、C混合型2例(1.71%), A、C混合型2例(1.71%). B基因型在轻度慢乙肝组所占的比例显著高于中、重度慢乙肝组(χ2 = 8.27、11.98, P = 0.004、0.001)、ASC组(χ2 = 5.46, P = 0.02)、CLF组(χ2 = 4.13, P = 0.042)和LC/HCC组(χ2 = 11.3, P = 0.001). C基因型在LC/HCC组和重度慢乙肝组所占的比例均显著高于轻度慢乙肝组(χ2 = 11.3, P = 0.001;χ2 = 8.78, P = 0.003), 与其他各临床型组间的比较则无显著性差异(P>0.05). C基因型在HBV DNA( )组和HBeAg(-)组r所占的比例均分别显著高于HBV DNA(-)组(χ2 = 6.63, P = 0.01)和HBeAg( )组(χ2 = 7.12, P = 0.008). B基因型在HBV DNA低水平复制组中所占的比例显著高于高水平复制组(χ2 = 4.12, P = 0.042). C基因型在HBV DNA高水平复制组中所占的比例显著高于B基因型(χ2 = 3.89, P<0.05). C基因型在年龄≥30岁组中所占的比例(63.3%)高于年龄<30岁组(45.6%)(χ2 = 3.7, P = 0.05). HBV基因型在性别间的分布无统计学差异(P>0.05)结论:云南地区存在HBV的B、C、D、B C和A C基因型, 以B型和C型为主要基因型, 并以C型为最多. B基因型在轻度慢乙肝的比例显著高于其他各临床型HBV感染者, 并且与HBV的低水平复制和低年龄有关. C基因型主要分布于重度慢乙肝和LC/HCC、HBV DNA高水平复制、年龄≥30岁的患者中. 提示C基因型与慢乙肝重度、肝硬化、肝细胞肝癌及HBV DNA高水平复制关系密切.     

Cancer survival in Songkhla, Thailand, 1990-1999

The Songkhla registry, besides being hospital-based, has population-based cancer registration data available since 1990. Cancer registration is done by active methods. The registry is contributing data on survival for 36 cancer sites or types registered during 1990-1999. Follow-up has been carried out by passive and active methods with median follow-up ranging from 3-71 months for different cancers. The proportion with histologically verified diagnosis for various cancers ranged between 52-100%; death certificate only (DCO) cases comprised 0-34%; 54-93% of total registered cases were included for survival analysis. Complete followup at five years ranged from 50-85% for different cancers. Five-year age-standardized relative survival rates of common cancers were cervix (59%), lung (7%), breast (59%), thyroid (86%), oesophagus (11%), liver (2%), nonmelanoma skin (75%), colon (45%) and oral cavity (33%). Five-year relative survival by age group did not reveal any pattern or trend and was fluctuating. A majority were diagnosed with regional spread of disease, and survival decreased with increasing clinical extent of disease.     

Reproductive variables and risk of breast malignant and benign tumours in Yunnan province, China

Introduction and aim: To compare reproductive factor influence on patients with pathological diagnosedmalignant and benign tumor in the Breast Department, The First Peoples’ Hospital of Kunming in Yunnanprovince, China. Methods: A hospital-based case-control study was conducted on 263 breast cancer (BC) casesand 457 non-breast cancer controls from 2009 to 2011. The cases and controls information on demographics,medical history, and reproductive characteristics variables were collected using a self-administered questionnaireand routine medical records. Histology of breast cancer tissue and benign breast lesion were documented bypathology reports. Since some variables in data analysis had zero count in at least one category, binomial-responseGLM using the bias-reduction method was applied to estimate OR’s and their 95% confidence intervals (95%CI). To adjust for age and menopause status, a compound variable comprising age and menopausal status wasretained in the statistical models. Results: multivariate model analysis revealed significant independent positiveassociations of BC with short menstrual cycle, old age at first live birth, never breastfeeding, history of oralcontraception experience, increased number of abortion, postmenopausal status, and nulliparity. Categorisedby age and menopausal status, perimenopausal women had about 3-fold and postmenopausal women had morethan 5-fold increased risk of BC compared to premenopausal women. Discussion and Conclusion: This study hasconfirmed the significant association of BC and estrogen related risk factors of breast cancer including longermenstrual cycle, older age of first live birth, never breastfeeding, nulliparity, and number of abortions morethan one. The findings suggest that female hormonal factors, especially the trend of menopause status play asignificant role in the development of BC in Yunnan women     

Monitoring and evaluation of a model demonstration project for the control of cervical cancer in Nakhon Phanom province, Thailand

Cancer of the uterine cervix is the second most common cancer in females in the world with about half a million new patients per year. Since the introduction by Papanicolaou of cervical smear screening, the incidence of cervical cancer has declined in many developed countries. The decrease in the incidence of and mortality from cervical cancer is mainly due to the organized mass screening using Pap smear programmes. Uterine cervical cancer is the leading cancer among women in Thailand with age-standardized incidence rates of 24.7 per 100,000 in 1999. Most cases present at advanced stages with poor prognoses of survival and cure. In the present study, cervical cancer screening programme with cervical cytology was organized for Nakhon Phanom province, Thailand. The specific objectives were: 1) to evaluate the reduction in incidence and mortality from cervical cancer in the province by means of an organised low-intensity cervical cytology programme. 2) to demonstrate the different aspects of programme implementation as a potential model for nationwide implementation. The screening activities were integrated in the existing health care system. Organized screening for women in the target population (aged 35-54 years) at 5-year intervals was free of charge. Sample taking was done by trained nurses (midwives) and primary health care personnel in the local health care centers. Sample quality was under continuous controlled by the cytology laboratories and pathologists. Confirmation and treatment were integrated into the normal health care routines. The screening results of the programme, including histologically confirmed diagnosis, were registered at the National Cancer Institute using PapReg and CanReg 4 programmes. A population-based cancer registry in Nakhon Phanom province was also set up in 1997. In the period 1999-2002, 32,632 women aged 35-54 years were screened. Women with low-grade lesions returned for routine follow-up smears. High-grade preinvasive disease was further evaluated by repeating Pap smear, conization or biopsy and subsequent treatment through surgical removal or ablation. This organized low-intensity cervical cytology programme showed a considerable increase in early carcinoma in situ and CIN II -III cases and should reduce incidence of and mortality from cervical cancer in Nakhon Phanom province in the future. Screening with the Papanicolaou smear plus adequate follow-up diagnosis and therapy can achieve major reductions in both incidence and mortality rates.