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高危型人乳头瘤病毒对宫颈癌及癌前病变诊断价值的探讨 总被引:2,自引:1,他引:1
为了探讨高危型人乳头瘤病毒(HPV)检测在宫颈癌及癌前病变中的诊断价值,采用第2代杂交捕获(HC-2)技术对325例妇科疾病患者[慢性宫颈炎56例,宫烦上皮内瘤变(CIN)Ⅰ41例,CIN Ⅱ 33例,CIN Ⅲ 91例,宫颈癌104例]进行HPV DNA阳性率和含量浏定.慢性宫颈炎、CIN Ⅰ级、CIN Ⅱ~Ⅲ级和宫颈癌患者HPV阳性感染率分别为35.7%,61.0%,91.0%和100.0%o;宫颈癌前病变(CIN I~Ⅲ)和宫颈癌的HPV DNA含量均明显高于慢性宫颈炎,差异有统计学意义,P<0. 05;宫颐癌的HPV DNA含量明显高于宫颈癌前病变(CINⅠ~Ⅲ),差异有统计学意义,P<0.05.初步研究结果提示,HPV DNA阳性感染率随宫颈病变程度的加重而升高;高危型HPV在慢性宫颈炎、CIN和宫颈癌中的病毒含量随宫颈病变程度的加重呈上升趋势.高危型HPV可以作为宫颈癌及癌前病变的重要检测指标. 相似文献
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人乳头瘤病毒(HPV)持续感染是宫颈上皮内瘤变和宫颈癌发生的必要因素.以治疗HPV感染为出发点研制有效的治疗性疫苗是防治宫颈癌的新策略.近年来,治疗性HPV疫苗的研制与试验已取得了巨大的进步,载体的选择、佐剂的使用、融合和嵌合蛋白的合成被广泛应用于研究中,以增强疫苗免疫原性、加强接种安全性、减少不良反应等.临床试验结果令人鼓舞,各类疫苗能诱导特异性免疫应答,且具有良好的耐受性;但如何取得进一步的成功依然需要大量的研究.此外,HPV病毒种类繁多,如何扩大疫苗的作用范围及减少免疫逃逸也是研究的重点. 相似文献
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目的:评价杂交捕获法和基因芯片法检测宫颈人乳头瘤病毒(human papillomavirus ,HPV )感染的方法学优势,探讨HPV 的多重感染以及HPV 病毒负荷量与不同级别宫颈病变的相关性。方法:分别采用基因芯片法和杂交捕获法对360 例宫颈癌机会性筛查的患者进行HPV-DNA的检测以及液基细胞学检测,并以基因测序为金标准评价两种检测方法的灵敏度、特异度。结果:基因芯片法和杂交捕获法的灵敏度、特异度和约登指数分别为前者98.33% 、93.40% 和0.917,后者97.56% 、98.17% 和0.957。按宫颈液基细胞学检查结果分为NSIL组、ASC 组、LSIL 组及HSIL和SCC 组,随宫颈细胞病变程度的增加,HPV 感染率、高危型HPV 感染率、多重感染率病毒逐渐增加,在宫颈上皮正常组与异常组间比较差异有统计学意义,低危型HPV 感染率无规律性改变。结论:两种HPV 检测方法相比,基因芯片法灵敏度较高,杂交捕获法特异度较高,基因芯片法可作为宫颈病变筛查方法;HPV的多重感染和病毒负荷量增加都与宫颈病变程度有一定的相关性。 相似文献
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宫颈癌相关抑癌基因及其与人乳头瘤病毒的关系 总被引:1,自引:0,他引:1
人乳头瘤病毒(HPV)感染是宫颈癌发生最主要的危险因素,其中心环节是HPV E6、E7蛋白与细胞癌基因和抑癌基因相互作用引起细胞永生化而癌变,其中癌基因的表达和抑癌基因功能的丧失是细胞癌变的分子基础.在已发现的数个抑癌基因中,p53、ING1、FHIT、survivin、p16INK4A与HPV相关宫颈癌关系密切,使得在检测宫颈癌及其癌前病变、预测病变进展、判断预后和宫颈癌的基因靶向治疗等方面有潜在的临床应用价值. 相似文献
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目的:探讨人乳头瘤病毒(humanpapillomavirus,HPV)与宫颈癌前病变(cervical intraepithelial neoplasia,CIN)和宫颈癌的关系以及与它们的预后关系。方法:采用第2代杂交捕获试验法检测我院门诊和住院患者994例随访手术治疗患者99例,随访患者同时行宫颈细胞学、阴道镜检查,以病理结果为金标准,按宫颈病变严重程度比较高危型HPV的检出率,以及比较术前术后宫颈癌前病变、宫颈癌感染高危型HPV变化情况。结果:以HPVDNA≥1.0Pg/mL,为阳性标准,慢性宫颈炎、CIN各组及宫颈癌分别为46.92%(206/439)、65.71%(23/35)、81.82%(36/44)、98.41%(62/63)、82.32%(340/413)。随访患者细胞学,阴道镜检查除1例CIN3患者为阳性,其余均为阴性,术后HPV持续阳性率为21.18%,其中1例诊断为宫颈原位癌。结论:高危型HPV感染与宫颈癌前病变和宫颈癌有明显相关性;宫颈锥切术后HPV持续阳性患者为复发的高危人群,应严密随访。 相似文献
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人乳头瘤病毒(HPV)感染,尤其是致癌基因型,是宫颈癌发生发展的重要危险因素,其分布具有地理差异和种族特异性,而可以降低HPV感染及相关疾病发生率的预防性疫苗成为宫颈癌治疗的新希望。 相似文献
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目的:了解维、汉族妇女宫颈鳞癌组织中人乳头瘤病毒(HPV)感染及其基因型的分布情况,并进一步探讨HPV感染及其基因型在维、汉族妇女宫颈鳞癌之间的分布是否有差异。方法:采用可检测23种HPV基因型的基因芯片方法分别检测30例维吾尔族宫颈鳞癌组织及30例汉族宫颈鳞癌组织的HPV基因型。结果:60例宫颈鳞癌组织中HPV的阳性率为95%(57/60),其中维吾尔族宫颈鳞癌HPV的阳性率为96.6%(29/30),汉族宫颈鳞癌HPV的阳性率为93.3%(28/30),差异无统计学意义(P〉0.05)。60例宫颈鳞癌组织中共检测到6种HPV基因型,分别为HPV16,56,58,18,68,35,均为高危型感染;其中HPV16最常见,检出率为91.7%(55/60),其次是HPV56,21.7%(13/60);另外,60例宫颈鳞癌中共检测到HPV双基因型重复感染22例,检出率36.7%(22/60)。结论:HPV感染与维、汉族妇女宫颈鳞癌关系密切,尤其以HPV16型最有关,其次为HPV56型,并存在一定数量的多亚型重复感染。HPV感染在维、汉族妇女宫颈鳞癌之间无差异。 相似文献
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目的:了解维、汉族妇女宫颈鳞癌组织中人乳头瘤病毒(HPV)感染及其基因型的分布情况,并进一步探讨HPV感染及其基因型在维、汉族妇女官颈鳞癌之间的分布是否有差异.方法:采用可检测23种HPV基因型的基因芯片方法分别检测30例维吾尔族宫颈鳞癌组织及30例汉族官颈鳞癌组织的HPV基因型.结果:60例宫颈鳞癌组织中HPV的阳性率为95%(57/60),其中维吾尔族宫颈鳞癌HPV的阳性率为96.6%(29/30),汉族宫颈鳞癌HPV的阳性率为93.3%(28/30),差异无统计学意义(P>0.05).60例宫颈鳞癌组织中共检测到6种HPV基因型,分别为HPV16,56,58,18,68,35,均为高危型感染;其中HPV16最常见,检出率为91.7%(55/60),其次是HPV56,21.7%(13/60);另外,60例宫颈鳞癌中共检测到HPV双基因型重复感染22例,检出率36.7%(22/60).结论:HPV感染与维、汉族妇女宫颈鳞癌关系密切,尤其以HPV16型最有关,其次为HPV56型,并存在一定数量的多亚型重复感染.HPV感染在维、汉族妇女宫颈鳞癌之间无差异. 相似文献
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Mass vaccination against human papillomavirus (HPV) genotypes 16 and 18 will, in the long term, reduce the incidence of cervical cancer, but screening will remain an important cancer control measure in both vaccinated and unvaccinated women. Since the 1960s, cytology screening has helped to reduce the incidence of cervical cancer, but has a low sensitivity for high-grade cervical intraepithelial neoplasia (CIN) and requires frequent testing. Several HPV tests have become available commercially. They appear to be more sensitive for high-grade CIN, and may further reduce the incidence of cervical cancer compared with cytology. However, they are associated with an increased frequency of positive tests without underlying CIN, and therefore increase the need for colposcopy and repeated testing. This problem will pose a major challenge for switching from cytology-based to HPV-based screening. The aim of this article is to discuss the role and the use of HPV tests and HPV genotyping in unvaccinated women. 相似文献
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《Expert review of anticancer therapy》2013,13(7):1025-1033
Mass vaccination against human papillomavirus (HPV) genotypes 16 and 18 will, in the long term, reduce the incidence of cervical cancer, but screening will remain an important cancer control measure in both vaccinated and unvaccinated women. Since the 1960s, cytology screening has helped to reduce the incidence of cervical cancer, but has a low sensitivity for high-grade cervical intraepithelial neoplasia (CIN) and requires frequent testing. Several HPV tests have become available commercially. They appear to be more sensitive for high-grade CIN, and may further reduce the incidence of cervical cancer compared with cytology. However, they are associated with an increased frequency of positive tests without underlying CIN, and therefore increase the need for colposcopy and repeated testing. This problem will pose a major challenge for switching from cytology-based to HPV-based screening. The aim of this article is to discuss the role and the use of HPV tests and HPV genotyping in unvaccinated women. 相似文献
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子宫颈癌是妇科最常见的恶性肿瘤,研究证实99.7%的宫颈癌是因感染人乳头瘤病毒(human papillomavirus,HPV)造成的,但几乎所有的研究中都发现有HPV检测阴性的子宫颈癌存在。HPV检测阴性的子宫颈癌可以概括为假阴性和真阴性两种情况,造成假阴性的原因有病变小、取材有限、病毒载量低、非高危人乳头瘤病毒基因型、技术错误或检测灵敏度不足等。现有的筛查方式具有一定局限性,一些具有高灵敏度和特异性的新型分子标记物如微小核糖核酸、FAM19A4基因甲基化等已被证明有望作为子宫颈癌早期检测和诊断的指标。近年来关于HPV阴性子宫颈癌的研究越来越多,但对HPV阴性子宫颈癌患者临床特点的分析存在差异。本文主要对HPV阴性子宫颈癌假阴性的原因、筛查诊断及临床特点方面进行综述。 相似文献
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Janet S. Rader Shirng-Wern Tsaih Daniel Fullin Miriam W. Murray Marissa Iden Michael T. Zimmermann Michael J. Flister 《International journal of cancer. Journal international du cancer》2019,144(9):2206-2214
Cervical cancer is driven by persistent infection of human papillomavirus (HPV), which is influenced by HPV type and intratypic variants, yet the impact of HPV type and intratypic variants on patient outcomes is far less understood. Here, we examined the association of cervical cancer stage and survival with HPV type, clade, lineage, and intratypic variants within the HPV E6 locus. Of 1,028 HPV-positive cases recruited through the CerGE study, 301 were in-situ and 727 were invasive cervical cancer (ICC), with an average post-diagnosis follow-up of 4.8 years. HPV sequencing was performed using tumor-isolated DNA to assign HPV type, HPV 16 lineage, clade, and intratypic variants within the HPV 16 E6 locus, of which nonsynonomous variants were functionally annotated by molecular modeling. HPV 18-related types were more prevalent in ICC compared to in-situ disease and associated with significantly worse recurrence-free survival (RFS) compared to HPV 16-related types. The HPV 16 Asian American lineage D3 and Asian lineage A4 associated more frequently with ICC than with in situ disease and women with an intratypic HPV 16 lineage B exhibited a trend toward worse RFS than those with A, C, or D lineages. Participants with intratypic E6 variants predicted to stabilize the E6–E6AP–p53 complex had worse RFS. Variants within the highly immunogenic HPV 16 E6 region (E14–I34) were enriched in ICC compared to in-situ lesions but were not associated with survival. Collectively, our results suggest that cervical cancer outcome is associated with HPV variants that affect virus-host interactions. 相似文献
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目的:探讨子宫颈癌发病机制中HPV感染对错配修复(mismatch repair,MMR)基因表达影响的意义。方法:77例子宫颈鳞癌标本采用免疫组织化学SP法检测HPV16、hM—SH2与hMLH1的表达。并分析这些表达与临床病理参数的关系。结果:HPV感染与非感染组子宫颈癌hM—LH1的阳性表达率分别为69.0%(29/42)和40.8%(12/28),rs=0.260,P=0.029;hMSH2的阳性表达率分别为64.2%(27/42)和46.4%(13/28),n=0.177,P=0.143。HPV感染、hMLH1及hMSH2阳性表达率与分化程度、临床分期及淋巴结转移无显著相关。结论:HPV感染组细胞hMSH2与hMLH1蛋白表达上调的现象表明HPV16感染增加子宫颈上皮细胞DNA复制时的碱基错配。因此,这可能是HPV16的致癌机制之一。 相似文献
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目的:探讨子宫颈癌发病机制中HPV感染对错配修复(mismatchrepair,MMR)基因表达影响的意义。方法:77例子宫颈鳞癌标本采用免疫组织化学SP法检测HPV16、hMSH2与hMLH1的表达。并分析这些表达与临床病理参数的关系。结果:HPV感染与非感染组子宫颈癌hMLH1的阳性表达率分别为69.0%(29/42)和40.8%(12/28),rs=0.260,P=0.029;hMSH2的阳性表达率分别为64.2%(27/42)和46.4%(13/28),rs=0.177,P=0.143。HPV感染、hMLH1及hMSH2阳性表达率与分化程度、临床分期及淋巴结转移无显著相关。结论:HPV感染组细胞hMSH2与hMLH1蛋白表达上调的现象表明HPV16感染增加子宫颈上皮细胞DNA复制时的碱基错配。因此,这可能是HPV16的致癌机制之一。 相似文献
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HPV在宫颈癌发病中的作用机制研究 总被引:7,自引:0,他引:7
宫颈癌是多因素协同作用引发的疾病,人乳头瘤病毒(HPV)在宫颈癌发病中起重要作用.现从流行病学、分子生物学、免疫学等方面对HPV在宫颈癌发病中的作用机制作一综述. 相似文献