盆腔淋巴结HPV-DNA检出率与早期宫颈癌临床转移的关系

目的 探讨早期宫颈癌患者盆腔淋巴结HPV-DNA检出与组织病理学确定的淋巴结转移之间的关系.方法 采用HPV通用引物PCR直接测序法扩增31例官颈癌原发部位肿瘤组织及盆腔淋巴结组织HPV-DNA L1区基因序列,分析淋巴结组织中HPV阳性率与临床病理特征之间的关系.结果 31例盆腔淋巴结中HPV-DNA检出率为58.1％.13例组织病理学确认有淋巴结转移的组织中HPV-DNA检出率为84.6％.18例组织病理学检查无淋巴结转移的盆腔淋巴结 HPV-DNA检出率为27.8％.盆腔淋巴结组织病理学确认转移与HPV-DNA检出有关.组织病理学检查和HPV-DNA检测均提示阳性淋巴结中闭孔、髂内、髂外这三组淋巴结占90％以上.结论 盆腔淋巴结HPV-DNA检出阳性是一个有意义的淋巴结转移预测因子.闭孔、髂内、髂外三组淋巴结是最主要的前哨淋巴结.     

代谢组学在妇科常见肿瘤治疗和预后评估中的应用

卵巢癌、子宫内膜癌和宫颈癌是妇科常见的三大恶性肿瘤,尽管随着手术、放化疗等综合治疗的不断发展,妇科常见恶性肿瘤患者的预后得到了大幅提升,但由于早期没有明显症状且缺乏准确诊断或发现时已是晚期,仍有相当比例的患者预后不佳,生命受到严重威胁。因此,寻找新的治疗靶点和监测疗效的有效标志物至关重要。代谢组学（metabonomics）是肿瘤研究领域颇受关注的研究方法,其理论基础是肿瘤存在有别于正常组织的代谢特征,肿瘤独特的代谢特征与生物表型存在紧密的关联。代谢组学通过对生物系统中内源性代谢物进行全面分析,阐明肿瘤在发生和进展过程中某些关键生化途径的重塑机制,并对其进行解析与精准干预。综述代谢组学在妇科常见肿瘤治疗和预后评估中的应用,预期其可为妇科常见肿瘤的个性化、精准化治疗提供潜在靶点,为妇科常见肿瘤筛选预后生物标志物提供重要参考。     

前牵引治疗不同时期上颌发育不足患者疗效评价

目的 应用头颅定位侧位片分析上颌发育不足患者在不同生长发育阶段进行前牵引治疗的临床效果。方法 选取2018年1月至2020年12月于上海交通大学附属第九人民医院口腔正畸科完成前牵引治疗的上颌发育不足患者36例,根据头颅定位侧位片颈椎骨龄分期（cervical vertebral maturation method,CVM）,分为生长发育高峰前期组（CVMⅠ～Ⅱ期）7例、生长发育高峰期组（CVMⅢ～Ⅳ期）17例以及生长发育后期组（CVMⅤ～Ⅵ期）12例。各组患者治疗前后分别拍摄头颅定位侧位片,对其软硬组织相关指标进行测量分析。结果 骨性矢状向指标上牙槽座角（SNA角）、上颌突距（A-Np）、前鼻嵴点至垂直参考轴的距离（VRL-ANS）、上牙槽座点至垂直参考轴的距离（VRL-A）、有效上颌长度（Co-A）、上下牙槽座点交角（ANB角）、Wits值在3组治疗前后的差异均有统计学意义（P <0.05）,其中治疗后生长发育高峰前期组A-Np改变值[（2.61±1.11）mm]与生长发育后期组[（1.00±0.82）mm]相比,差异有统计学意义（P=0.017）;骨性垂直向指标腭平面倾斜角（...     

鼻咽癌治疗后颈淋巴结残留或复发的彩色多普勒信号特征

目的 探讨彩色多普勒检查时鼻咽癌治疗后颈淋巴结残留或复发的多普勒信号特征.方法 51枚颈转移淋巴结经术后病理确诊鼻咽痛治疗后颈淋巴结残留或复发(共计12例患者),24枚淋巴结为反应性增生良性淋巴结(共计6例患者),手术前行彩色多普勒检查.结果 鼻咽痛治疗后颈淋巴结残留或复发的淋巴结发生部位在Ⅱ.Ⅳ区.短轴直径＞10 m...     

Chondrosarcoma of the cervical vertebra: a case report

Summary A rare case of cervical chondrosarcoma is presented and its clinical behavior and treatment modalities are discussed.     

两种液基薄层细胞学方法筛查宫颈上皮内瘤样病变的评价

目的对2种液基薄层细胞学方法筛查宫颈癌和癌前病变的对比进行分析与评价,以期找到宫颈癌早期筛查质量好又经济的方案。方法2007年3～10月,对980例患者分别采用Hong Xiang细胞学检测系统(489例)和新柏氏薄层细胞学检测系统(TCT,491例)进行宫颈病变的早期筛查,对167例(HongXiang 82例,TCT 85例)细胞学阳性或临床可疑的患者行阴道镜下活组织检查。结果Hong Xiang检查的阳性率与TCT细胞学检查的阳性率比较差异无统计学意义(P>0.05);Hong Xiang细胞学检查在诊断宫颈低度病变、高度病变与宫颈癌的准确率上与TCT比较,差异无统计学意义(P>0.05)。结论Hong Xiang细胞学检测系统可以替代新柏氏薄层细胞学检测系统并降低耗材。     

Tisotumab vedotin in Japanese patients with recurrent/metastatic cervical cancer: Results from the innovaTV 206 study

New treatments, particularly second‐line options, are needed to improve outcomes for patients with recurrent/metastatic cervical cancer (r/mCC). Tisotumab vedotin (TV) is an antibody–drug conjugate directed to tissue factor, a transmembrane protein commonly expressed in cancer cells, to deliver cytotoxic monomethyl auristatin E. This single‐arm, open‐label phase 1/2 trial evaluated the consistency of safety and efficacy outcomes of TV in Japanese patients with r/mCC to bridge the current findings with those reported in previous trials in non‐Japanese patients in the United States and Europe. In part 1 (dose escalation; N = 6), patients with advanced solid tumors received TV 1.5 or 2.0 mg/kg once every 3 weeks to determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D). Part 2 (dose expansion; N = 17) evaluated the RP2D in r/mCC patients with 1–2 prior lines of therapy. In part 1, no dose‐limiting toxicities were observed, the MTD was not reached, and TV 2.0 mg/kg was established as the RP2D. In part 2, the most common treatment‐emergent adverse events were anemia (58.8%), nausea (58.8%), alopecia (47.1%), epistaxis (47.1%), and diarrhea (35.3%); adverse events of special interest were bleeding (76.5%), ocular events (35.3%), and peripheral neuropathy (17.6%), and were mostly grade 1/2. In part 2, confirmed objective response rate was 29.4%, median duration of response was 7.1 months, and median time to response was 1.2 months. In Japanese patients with r/mCC, TV demonstrated a manageable and tolerable safety, pharmacokinetics, and efficacy profile consistent with that observed in non‐Japanese patients.     

静止中立位状态及加载模拟头部重量后对髓核内压力影响的研究

目的:通过测试颈椎标本在静止中立位及模拟头部重量后的髓核内压力,从而探讨颈椎髓核内压力的变化规律。方法:利用生物力学材料实验机及微型压力传感器测试新鲜人体颈椎标本在静止中立位及加载100N压力时的髓核内压力。结果:静止中立位及加载100N压力时,C3～4和C4～5节段髓核内压力比较无显著性差异(P0.05),C5～6和C6～7节段髓核内压力比较无显著性差异(P0.05);C5～6,C6～7高于C3～4,C4～5髓核内压力(P0.05);加载100N后所有节段髓核内压力均升高具有显著性差异(P0.05)。结论:正常人体下颈段髓核内压力高于上颈段髓核内压力,并且随外在负荷的增加而压力增加。     

颈椎“骨错缝筋出槽”临床评价方法

结合临床研究结果 ,从关节功能评估和关节结构评估两个方面阐述＂骨错缝筋出槽＂临床特征的评价方法。关节功能评估包括动态触诊评估和颈椎自主活动度检测,关节结构评估包括静态触诊评估和影像学评估。     

Attitudes towards HPV testing: a qualitative study of beliefs among Indian,Pakistani, African-Caribbean and white British women in the UK

This study examined attitudes to human papillomavirus (HPV) testing among a purposively selected sample of women from four ethnic groups: white British, African Caribbean, Pakistani and Indian. The design was qualitative, using focus group discussion to elicit women's attitudes towards HPV testing in the context of cervical cancer prevention. The findings indicate that although some women welcomed the possible introduction of HPV testing, they were not fully aware of the sexually transmitted nature of cervical cancer and expressed anxiety, confusion and stigma about HPV as a sexually transmitted infection. The term 'wart virus', often used by medical professionals to describe high-risk HPV to women, appeared to exacerbate stigma and confusion. Testing positive for HPV raised concerns about women's sexual relationships in terms of trust, fidelity, blame and protection, particularly for women in long-term monogamous relationships. Participation in HPV testing also had the potential to communicate messages of distrust, infidelity and promiscuity to women's partners, family and community. Concern about the current lack of available information about HPV was clearly expressed and public education about HPV was seen as necessary for the whole community, not only women. The management of HPV within cervical screening raises important questions about informed participation. Our findings suggest that HPV testing has the potential to cause psychosocial harm to women and their partners and families.