人乳头瘤病毒与宫颈癌

大量的流行病学调查资料表明 ,宫颈癌可能是通过一些性传播因子引起的 ,其中已被广泛重视的性传播因子是病毒 ,尤其是人乳头瘤病毒 (ｈｕｍａｎｐａｐｉｌｌｏｍａｖｉｒｕｓ,ＨＰＶ)。目前已有 10 0种以上的ＨＰＶ型别被鉴定。依ＨＰＶ致病性不同 ,可将其分为低危和高危两大类别。前者包括ＨＰＶ -6 ,11,30 ,39,42 ,43 ,44等 ,可引起尖锐湿疣、扁平湿疣等良性病变 ,其中仅 1%进展为宫颈癌 ;后者包括与宫颈癌密切相关的ＨＰＶ - 16 ,18,31,33 ,35 ,45 ,5 1,5 2 ,5 6 ,5 8,6 1等型别。随着ＨＰＶ检测技术的发展 ,几乎在 10 0 %宫颈鳞状细胞癌…     

妊娠期子宫颈病变及人乳头瘤病毒感染的管理

文章系统地阐述了妊娠期子宫颈病变的流行病学和自然史、阴道镜检查指征、子宫颈生理变化和阴道镜图像特点、子宫颈病变分层管理原则。妊娠期HPV感染流行病学及其对妊娠、子宫颈病变结局、分娩方式的影响。     

人乳头瘤病毒致宫颈癌发病机制研究进展

人乳头瘤病毒感染是最常见的性传播性疾病，通常在感染后自行消失。只有持续的高危型人乳头瘤病毒感染才是导致宫颈癌的根本原因。其致癌的中心环节是E6，E7与p53和Rb的相互作用，从而导致p53通路（p14-MDM2-p53通路）和Rb通路（p16-CDK4/cyclin D1-pRb通路）功能失活，这是宫颈癌的发病基础。此外，影响宫颈癌发生的主要辅助因素包括环境因素、宿主因素和病毒因素等。     

福州地区8175例宫颈人乳头瘤病毒感染情况分析

<正>目前,已发现有200多种HPV亚型,其中15种高危型感染与宫颈上皮内瘤变(CIN)和癌的发生密切相关。临床上几乎所有宫颈癌组织均可检测到HPV感染,HPV感染与宫颈癌的相关性具有普遍意义。因此,已有相当一部分女性将LCT筛查和HPV检测列入自己的年度体检表。各个国家、     

人乳头瘤病毒预防性疫苗现状和问题

宫颈癌在妇女恶性肿瘤中的发病率仅次于乳腺癌。持续性高危型人乳头瘤病毒（HPV）感染导致了几乎所有浸润性宫颈癌的发生。人乳头瘤病毒与宫颈癌之间较为明确的病因学联系使得人乳头瘤病毒预防性疫苗的研发有望从“源头”上遏制宫颈癌。由于病毒型别特异性，人群筛查宫颈癌仍然占有重要地位。目前，第一代人乳头瘤病预防性疫苗的实际推广应用面临许多争议和需要解决的问题。     

人乳头瘤病毒预防性疫苗现状和问题

宫颈癌在妇女恶性肿瘤中的发病率仅次于乳腺癌.持续性高危型人乳头瘤病毒(HPV)感染导致了几乎所有浸润性宫颈癌的发生.人乳头瘤病毒与宫颈癌之间较为明确的病因学联系使得人乳头瘤病毒预防性疫苗的研发有望从"源头"上遏制宫颈癌.由于病毒型别特异性,人群筛查宫颈癌仍然占有重要地位.目前,第一代人乳头瘤病预防性疫苗的实际推广应用面临许多争议和需要解决的问题.     

广西沿海地区妇女宫颈癌患者人乳头瘤病毒（HPV）感染各亚型分布特点

目的探讨广西沿海地区妇女宫颈癌患者人乳头瘤状病毒（human papillomavirus,HPV）感染分布情况及主要型别,为广西沿海地区临床防治宫颈癌、研制适合该地区的预防性HPV疫苗提供理论依据。方法采用人乳头瘤病毒核酸扩增分型检测试剂盒方法,对76例广西沿海地区妇女经病理确诊宫颈癌患者的宫颈脱落细胞进行HPV基因分型检测。结果 76例宫颈癌患者中有69例HPV阳性,阳性率为90.8%,其中,HPV16感染率最高为56.5%,其他高危型的感染率从高到低依次为HPV18、33、58、52、53、31、45、35、39、51、56、66、68。低危型中HPV6型感染率最高为5.8%,其他低危型的感染率从高到低依次为HPV11、43、44。多重感染率为20.3%。正常对照组60例中有13例HPV阳性（21.7%）。其中,13例阳性标本中,HPV16感染率最高为30.8%,其他高危型HPV31、52、53感染率为15.4%,低危型HPV11、43、44感染率为7.7%。宫颈癌HPV阳性率明显高于正常对照组,差异有统计学意义（P〈0.005）。结论广西沿海地区妇女宫颈癌患者中以HPV16、18、33、58感染为主要型别,可能是广西沿海地区妇女宫颈癌较易感染的型别。     

人乳头瘤病毒致宫颈癌发病机制研究进展

人乳头瘤病毒感染是最常见的性传播性疾病,通常在感染后自行消失.只有持续的高危型人乳头瘤病毒感染才是导致宫颈癌的根本原因.其致癌的中心环节是E6,E7与p53和Rb的相互作用,从而导致p53通路(p14-MDM2-p53通路)和Rb通路(p16-CDK4/cyclin D1-pRb通路)功能失活,这是宫颈癌的发病基础.此外,影响宫颈癌发生的主要辅助因素包括环境因素、宿主因素和病毒因素等.     

性激素在人乳头瘤病毒感染中的作用

人乳头瘤病毒（ＨＰＶ）感染是常见的ＳＴＤ之一，ＨＰＶ具有潜在的致癌性，但需要协同因子的作用。近来发现，性激素不仅调控ＨＰＶ基因表达，也与细胞癌性转化有关，抗雌激素治疗ＨＰＶ相关病变有一定效果，而且在其病毒基因组中发现有类固醇激素应答元件，提示性激素是ＨＰＶ致病的重要协同因子。     

人乳头瘤病毒和沙眼衣原体感染与子宫颈癌关系的研究

子宫颈癌是女性常见的恶性肿瘤之一 ,一般认为其发病主要与性传播疾病的微生物感染有关。本文对我国部分健康女性及子宫颈上皮内瘤样病变 (ＣＩＮ)和宫颈鳞状细胞癌 (ＳＣＣ)患者的ＨＰＶ及ＣＴ感染状况进行了研究 ,并用多因素分析的统计学方法探讨了ＨＰＶ各型及ＣＴ感染与ＣＩＮ及ＳＣＣ的关系 ,以及ＨＰＶ感染与ＣＴ感染的关系。1　资料与方法1.1研究对象1995年 8月至 1996年 9月我们在沈阳市内四所医院妇产科共收集了 435例子宫颈部脱落细胞 ,被检者年龄为18～ 76岁 (平均为 45岁 ) ,除外性传播性疾病。经临床检查和宫颈细胞病理学诊断 …     

孕期人乳头瘤病毒感染分型与母婴垂直传播

目的探讨孕期人乳头瘤病毒(HPV)感染及母婴传播情况。方法运用PCR结合DNA探针杂交检测法对2006年1月至12月南京市鼓楼医院不同孕期的405例孕妇宫颈脱落细胞进行HPV-DNA分型检测,阳性孕妇的新生儿出生洗净后对其口咽部和生殖器黏膜细胞进行HPV-DNA分型检测,对各自感染率及感染分型进行分析。结果405例孕妇中71例感染HPV病毒,感染率为17.5%;宫颈光滑组定为宫颈正常组,其HPV病毒感染率为5.6%(12/214);宫颈病变组感染率为30.9%(59/191);孕期被检出的型别有16、18、31、33、35、43、56、58、6、11型,分别占HPV感染的37.7%、7.8%、7.8%、6.5%、1.3%、3.9%、2.5%、10.4%、9.1%、13.0%。57例新生儿中,16例感染HPV病毒,感染率28.1%;感染型别有16、11、6、35、31、58,除1例外均与其母亲感染型别相同,经阴道顺产与经剖宫产分娩的新生儿HPV病毒感染率分别为19.4%(6/31)和38.5%(10/26)。结论孕期存在HPV病毒感染,以16型病毒感染为主,宫颈病变与HPV病毒感染关系密切;HPV病毒存在垂直传播,以16型病毒为主。     

Smoking and genital human papilloma virus infection in women attending cervical cancer screening in Greece

AIM: To investigate whether smoking is associated with human papilloma virus (HPV) infection. METHODS: HPV infection is considered to be a necessary condition for cervical cancer development. The study population included 1291 women, aged 25-55 years, attending cervical cancer screening. All women had a Papanicolaou (Pap) test, with liquid-based cytology (Thinprep^®), an HPV-DNA test and an evaluation of smoking habits. The COBAS^® 4800 system was used for HPV-DNA testing, enabling identification of the following high-risk HPV (hrHPV)-types: each of HPVs 16 and 18 separately, and HPVs 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 as a cocktail. The evaluation of smoking habits was assessed using the smoking intensity index (SII), a variable formed as the product of cigarettes consumed per day by the days (years × 365) that a woman was a smoker, divided by 1000. RESULTS: There were 136 smokers among 238 women tested positive for hrHPV-types (HPVs 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and/or 68), and 463 smokers among 1053 hrHPV-negative women (OR = 1.7, P < 0.001). This association was attributed to the youngest age group of women, aged 25-34 years (OR = 2.3, P < 0.001), while there was no association in other age groups. The intensity of smoking (increasing SII) showed no statistically significant association with hrHPV infection. Cervical infection with HPV 16 and/or HPV 18 was also not associated with age or smoking habits. Finally, no association was found between Pap test status and smoking habits or smoking intensity. CONCLUSION: Smoking appears to be associated with hrHPV infection of the uterine cervix, particularly in younger women. Further studies should investigate whether this association is based on causality and evaluate the role of other possible co-factors.     

Adeno-associated virus and human papillomavirus types in cervical samples of pregnant and non-pregnant women

Objective

To investigate the prevalence of AAV and HPV DNA and their types in cervical secretion from pregnant and non-pregnant women.

Study design

The samples were obtained from 40 pregnant and 62 non-pregnant women who were attended at the outpatient clinic of the Federal University Hospital of Espírito Santo, Southeastern Brazil. AAV and HPV were investigated by PCR and typed by PCR and/or RFLP.

Results

The occurrence of AAV in all samples was 25.5% (26/102): 81% (21/26) and 19% (5/26) for AAV2/3 and AAV5 species, respectively. AAV were observed in 35% (14/40) and 19% (12/62) of pregnant and non-pregnant women, respectively. HPV occurred in 22% of all samples; 25% (10/40) in pregnant and 20% (12/60) in non-pregnant women. HPV types were determined for 72.7% of the strains, most of which classified as high-risk. AAV–HPV co-infection was observed in 15.4% (4/26), mostly in pregnant women.

Conclusions

There was a greater prevalence of AAV and HPV in pregnant than in non-pregnant women, which suggests that the gestational state may play a role in reactivating the viruses.     

Diabetic ketoacidosis among pregnant and non-pregnant women: a comparison of morbidity and mortality

Purpose: Diabetic ketoacidosis (DKA) is a critical diagnosis that can cause severe morbidity and mortality in the diabetic population. Although it is rare in pregnancy, the aim of this study is to compare DKA in pregnant women with age-matched non-pregnant women to determine if outcomes are influenced by pregnancy.

Materials and methods: A population-based age-matched retrospective cohort was carried out using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 1999 to 2013. Pregnant patients with DKA were age-matched with non-pregnant controls also admitted with DKA at a ratio of 1:10. Severe morbidities and mortality were compared among the two groups. Logistic regression was used to adjust for baseline characteristics and comorbidities.

Results: We identified 4661 cases of DKA in pregnancy during our study period, which were age-matched to 46,610 non-pregnant controls. Pregnant women with DKA were more likely to stay in hospital for >3 d (odds ratios (OR) 2.15, 95% CI 2.06–2.25) and had more associated renal failure (OR 2.86, 95% CI 1.76–4.55); however, they were less likely to require ventilation (OR 0.70, 95% CI 0.62–0.79), experience systemic inflammatory response syndrome (OR 0.53, 95% CI 0.38–0.73), or seizures (OR 0.49, 95% CI 0.42–0.57). Among pregnant women, rates of coma (0.04%) and death (0.17%, OR 0.23, 95% CI 0.14–0.39) were lower than previously reported and lower than non-pregnant women.

Conclusion: Pregnant women with DKA are admitted to hospital for longer periods than non-pregnant controls and are at higher risk for renal failure but otherwise have better outcomes and less mortality than non-pregnant controls.     

子宫内膜组织人乳头瘤病毒感染的初步研究

目的了解正常子宫内膜，宫颈癌患者子宫内膜以及子宫内膜癌组织HPV感染情况。方法选择HPVL1区改良通用型引物Gp5＋／Gp6＋，通过HPV—DNA扩增和DNA测序法，对2004年9月-2006年3月我院妇科收治的25例宫颈癌、30例子宫内膜癌患者的石蜡包埋组织进行HPV检测，以20例子宫肌瘤患者作为对照组。每例宫颈癌取癌组织及正常子宫内膜；每例内膜癌取癌组织及正常宫颈粘膜；每例子宫肌瘤取正常子宫内膜及宫颈粘膜。结果①25例宫颈癌病例中，16例宫颈癌组织及1例子宫内膜组织检测出HPV感染。这例子宫内膜与其相应的宫颈癌组织均为HPV-16型感染；②30例子宫内膜癌组织及其相应的宫颈粘膜组织均未检测出HPV—DNA，检出率均为0（0／30）；③对照组正常子宫内膜及宫颈粘膜均未检出HPV—DNA，检出率均为0（0／20）。结论①子宫内膜HPV感染很少，说明其可能不是HPV复制、成熟的适宜宿主组织；②宫颈癌患者子宫内膜组织的HPV可能由上行感染所致，但感染率较低；③子宫内膜癌的发生、发展可能与HPV无关。     

Interaction between BRCA1 and human papilloma virus E7: an ontology study

BRCA1 was the first breast cancer susceptibility gene to be identified and cloned. Recent studies indicate that BRCA 1 interacts with and regulates the activity of estrogen receptor alpha. The correlation between BRCA1 and E7 of papilloma virus becomes a new interesting topic in gynecological cancer. According to this study, E7 can add no function or aberration to the BRCA1 molecule. Further experimental studies are needed before making a conclusion on this topic. The finding in this study not only supports the previous knowledge on BRCA1 but also gives a new view on the function of BRCA1 and E7 in breast cancer. Here, the author used a new gene ontology technology to predict the molecular function and biological process of BRCA1 and E7.     

Investigation of the incidence of hepatitis E virus among pregnant women in Turkey

AIM: The aim of our study was to determine the prevalence of hepatitis E virus (HEV) among pregnant and non-pregnant women in Middle Anatolia, identify the factors that affect being HEV positive and to study the effects of HEV positivity on mother and fetus. METHODS: The study included 245 pregnant women who applied to various health centers and 76 cases in the same age range as the control. Blood samples taken from the cases were tested in terms of anti-HEV, IgM and IgG using the microELISA method. RESULTS: None of the blood samples tested revealed anti-HEV IgM positive, an indicator of acute infection, while 31 pregnant women (12.6%) and nine cases in the control group (11.8%) were found to have anti-HEV IgG positive (P > 0.05). It was seen that in pregnant women such factors as advanced age, lower educational and income levels and rural residence were correlated with higher anti-HEV IgG positive values (P < 0.05). HEV infection is endemic in Afyon and its vicinity. There were no statistical differences between pregnant women and non-pregnant women at similar ages in terms of HEV seropositivity. CONCLUSION: It can be suggested that pregnancy does not constitute a predisposition to HEV infection.     

沙眼衣原体感染与生殖道人乳头瘤病毒感染的关系及其与宫颈病变发生的相关性研究

目的研究女性生殖道人乳头瘤病毒(human papilloma virus,HPV)感染与沙眼衣原体(Chlamydia trachomatis,CT)感染的关系,及其与宫颈癌前病变和宫颈癌发生的相关性。方法以妇产科门诊患者540例为研究对象,所有患者均行HPV、CT和宫颈细胞学检查。对疑似宫颈病变的患者进一步行宫颈活检。根据HPV检测结果,将HPV检测阳性的患者140例设为观察组,HPV检测阴性的患者400例设为对照组,分析生殖道HPV感染与CT感染的相关性,以及其与宫颈病变发生的相关性。结果观察组宫颈病变发生率(21.4%)显著高于对照组(1.3%,P0.000 1)。按照HPV感染分型,进一步将观察组分为高危组(78例)、低危组(32例)和混合感染组(30例)。高危组(25.6%)和混合感染组(26.7%)宫颈病变发生率均显著高于低危组(6.3%,P=0.009;P=0.019)。同时,观察组CT感染率(27.1%)显著高于对照组(3.3%,P0.000 1)。HPV感染患者中,高危组(33.3%)和混合感染组(36.7%)的CT感染率均显著高于低危组(3.1%,P=0.021;P=0.019)。依据是否存在C T感染将观察组患者分为H P V单纯感染组和C T混合感染组。结果显示后者宫颈病变率(57.8%)显著高于前者(25.5%,P=0.046)。且CT混合感染组,高危HPV和混合HPV感染患者宫颈病变的发生率分别为39.3%和50.0%,均明显高于HPV单纯感染组中高危HPV和混合HPV感染患者,其发生率分别为16.0%和15.4%,差异均具有统计学意义(P=0.026和P=0.017)。Logistic回归分析显示高危型HPV感染(OR=2.180,P=0.018)、HPV和CT混合感染(OR=6.690,P=0.012)是宫颈病变发生的风险因素。结论女性生殖道CT感染与HPV感染密切相关,HPV和CT混合感染是宫颈癌前病变和癌变的独立风险因素。通过早期筛查女性生殖道HPV感染和CT感染,及时有效地治疗微生物混合感染,对进一步降低宫颈癌前病变和宫颈癌的发病率,提高临床治疗效果具有重要意义。     

妊娠合并乙型肝炎病毒感染围分娩期管理

对乙型肝炎(乙肝)病毒感染孕妇采取合理的围分娩期管理以阻断母婴垂直传播是降低我国慢性乙肝感染率的关键。新生儿出生后及时注射乙肝免疫球蛋白,并按照0、1、6方案接种乙肝疫苗,可有效阻断乙肝的围分娩期传播。孕妇在晚孕期进行抗病毒治疗可能通过降低母体病毒水平而减少围分娩期传播风险,但抗病毒药物对胎儿的安全性仍需进一步验证。