中国女性人乳头瘤病毒感染状况及高危型别分布的Meta分析

目的分析人乳头瘤病毒(human papillomavirus,HPV)在我国不同地区妇女中的感染情况及高危型别分布,以期为制定有效的地区宫颈癌防治策略及HPV疫苗的研制提供科学的基础数据。方法通过检索查询文献,综合分析并评价2011年7月前在国内发表的有关HPV在宫颈组织中感染及高危型别分布的相关研究。结果 HPV在我国普通女性中的感染率为15.71%,低于宫颈病变患者(15.71%vs82.43%,P0.05)。北方地区高危型HPV的平均感染率高于南方(41.57%vs14.81%,P0.05),少数民族自治区高危型HPV的平均感染率高于其他省市(56.36%vs 17.11%,P0.05)。全国范围内前6位常见高危型HPV分布依次为:HPV-16、HPV-52、HPV-58、HPV-33、HPV-18、HPV-31型。HPV-16型是我国最为常见的感染型别,其他型别在不同地区及人群中的分布有一定差异。结论 HPV的感染率及高危型别分布在我国不同地区及不同人群中有一定差异,HPV-16、HPV-52和HPV-58型是中国特有的优势感染型别。     

鸦胆子油乳对HPV16亚型感染细胞的作用及机制研究

目的研究鸦胆子油乳（bruceajavanicaoilemulsion,BJOE）在体外对人乳头瘤病毒（hu-manpapillomavirus,HPV）16亚型感染细胞的抑制作用及其可能作用机制。方法选择人宫颈鳞状上皮永生化细胞系（Ectl／E6E7）与人宫颈癌CaSki细胞系作为HPV16亚型感染的宫颈癌前病变与宫颈癌体外实验模型。采用MTT法检测5、10、20及40#g／mLBJOE体外分别作用24、48及72h对HPV16感染细胞增殖活性的影响;Hoechst33258细胞核染色荧光显微镜下观察细胞凋亡形态学变化;AnnexinV-FITC／Pl双染色法检测细胞凋亡率;半定量RT．PCR法检测HPV16E6、E7基因mRNA的表达;免疫细胞化学染色（Elivison二步法）检测HPV16E6、E7、p53及Rb基因蛋白的表达。结果（1）5、10、20及40μg,mLBJOE体外分别作用24、48及72h对HPV16感染细胞的增殖具有明显抑制作用,且表现为浓度与时间的依赖性（P〈0．05）。（2）HPV16阳性细胞在BJOE作用后发生了细胞凋亡形态学变化,5、10及20μg／mLBJOE体外作用48h后细胞凋亡率逐渐升高（P〈0．05）。（3）5、10及20μg／mLBJOE体外作用HPV16阳性细胞48h后E6与E7基因mRNA的相对表达量逐渐降低（P〈0．05）。（4）5、10及20μg,mLBJOE作用后,HPV16E6、E7及突变型P53蛋白的表达逐渐减弱（P〈0．05）,而Rb蛋白的表达逐渐增强（P〈0．05）。结论BJOE在体外对HPV16亚型感染细胞具有明显的抑制作用,其作用机制可能与药物下调病毒癌基因E6、E7表达相关。     

Magnetic resonance imaging of the cervix in women at high risk for preterm delivery

Objectives.?To assess whether changes in signal intensity of cervical stroma layers on magnetic resonance imaging (MRI) are associated with spontaneous preterm delivery.

Methods.?Prospective cohort study of women admitted for threatened late miscarriage or preterm delivery between 18 and 34 weeks of gestation. We performed T2-weighted low-field MRI of the uterine cervix among 100 women. Cervical stromal differentiation, defined as the contrast between signal intensities of the inner and outer cervical layers, was classified as high, intermediate, or low by a radiologist blinded to the participant's clinical report. The main outcome measure was the proportion of spontaneous preterm delivery.

Results.?Thirty-six women had a spontaneous preterm delivery. The proportion of spontaneous preterm delivery for high, intermediate, and low stromal differentiation was 7/24 (29%), 21/64 (33%; risk ratio 1.1; 95% confidence interval [CI]: 0.6–2.3), and 8/12 (67%; risk ratio 2.3; 95% CI: 1.1–4.8), respectively. The risk of delivering within 7 days increased when stromal differentiation decreased, although the difference was not statistically significant.

Conclusions.?The risk of spontaneous preterm delivery is increased in women with low cervical stromal differentiation on MRI. This risk is also associated with short cervical length, a measurement easier and less costly to obtain by transvaginal ultrasound.     

Relationship between endocervical canal length between 15–24 weeks gestation and obstetric history

The object was to determine whether there is a correlation between the obstetric history and the ultrasonographically determined endocervical canal length between 15 and 24 weeks gestation. A retrospective cohort study was performed in singleton pregnancies of multigravidas with normal and abnormal obstetric histories. They underwent sonographic evaluation for the determination of the endocervical canal length between 15 and 24 weeks gestation. The shortest endocervical canal length measurements between 15 and 20 weeks and also between 21 and 24 weeks of gestation were recorded. An ultrasound diagnosis of cervical incompetence was defined as progressive shortening of the endocervical canal length to > 2 cm or a single endocervical canal length measurement > 2 cm. A multivariable general linear regression model was used to correlate the relationship between endocervical canal lengths at 15–20 weeks and 21–24 weeks gestation in the current pregnancy with the earliest gestational age at delivery of prior pregnancies. Chi-square test was used to determine the relationship between the development of an ultrasound diagnosis of cervical incompetence and the earliest gestational age at delivery of prior pregnancies. A total of 155 pregnancies were studied. The number of women according to the obstetric history categories were: 57 had delivered > 24 weeks, 12 between 24 and 26 weeks, 16 between 27 and 32 weeks, 16 between 33 and 36 weeks, and 54 delivered 37 weeks. There was a significant correlation between the endocervical canal length measurements between 15–20 (P > 0.0001) weeks and 21–24 weeks (P > 0.0001) in the studied pregnancy and the earliest gestational age at delivery of prior pregnancies. A significant relationship between the ultrasound diagnosis of cervical incompetence and the obstetric history category (P = 0.0026) was observed. There were 36 cases of ultrasound diagnosed cervical incompetence with 91.7% (33/36) occurring in women who had a prior > 27 weeks' gestation delivery. These data provide further evidence that cervical incompetence is a relative condition and not an “all or none” phenomenon. In addition, women with a prior delivery > 30 weeks gestation should be followed with second trimester serial cervical sonography to rule out cervical incompetence.     

What Questions do People Ask on a Human Papillomavirus Website? A Comparative Analysis of Public and Private Questions

Objective: In 2004, we launched the question and answer (Q&A) section on a human papillomavirus (HPV) website (www.hpvkorea.org) that provides ample and regularly updated information about HPV. The purpose of this study is to collect data pertaining to questions posed on this website about HPV and its related diseases and analyze the type of questions and frequency before and after introduction of HPV vaccine in Korea. Using these results, we intend to determine the clinical and practical implications for doctors treating HPV and for HPV website providers.Method: Data were collected from March 2004 to July 2011. This study analyzed all the questions that were asked on the website during this period. The questions were categorized into 2 groups, according to whether they were asked publicly or privately. The 10 categories for classification were determined on the basis of the contents of the questions by 4 researchers with medical degrees (Ph.D.) related to HPV research. The frequency of the questions was separately determined for the public and private question formats. Also, we compared the type of questions and frequency before and after introduction of HPV vaccine in Korea and evaluated the changes in the 2 groups over the 2 periods studied.Results: Of the 3,062 subjects who visited the HPV website, 2,330 subjects asked public questions and 732 asked private questions. The most frequent question was “I have been infected with HPV, and I want to know about the treatment options for HPV infection and cervical dysplasia” (n = 1156, 37.8%), and the second most common question was “What are the transmission routes of HPV?” (n = 684, 22.3%). The third most common question was “How long does it take for HPV infection to spontaneously remit?” (n = 481, 15.7%).Of the 2,330 public questions, the most common question types pertained to the treatment of HPV and cervical dysplasia, HPV transmission, HPV remission, and risk of cervical cancer (in that order). Of the 732 private questions, the most frequent question types pertained to the HPV transmission, treatment of HPV and cervical dysplasia, genital warts, and HPV & pregnancy (in that order). The type and frequency of public and private questions showed statistical differences between the 2 groups (p < 0.001).Conclusion: Our results show that when people consult an internet site about HPV, they actually want to seek about “treatment of HPV and cervical dysplasia”, “HPV transmission”, “HPV remission”, “genital warts”, and “risk of cervical cancer” (in this order). Also, our results showed that “genital warts” and “HPV & pregnancy” may have been considered embarrassing topics. Thus, these findings can be used to make informed recommendations for future clinical or internet-based communications with patients and the general public.     

ARHI和环氧化酶-2蛋白在子宫颈腺癌组织中的表达及其意义

目的探讨ARHI蛋白和环氧化酶-2（COX-2）蛋白在子宫颈腺癌发生中的作用及其相互关系。方法采用免疫组织化学法检测40例子宫颈腺癌及30例慢性子宫颈炎组织中。ARHI蛋白及COX-2蛋白的表达情况。结果ARHI在40例子宫颈腺癌组织阳性率为50．0％（20／40）,低于慢性子宫颈炎患者子宫颈组织阳性率90．0％（27／30）,差异有统计学意义（X^2=12．43,P〈0．05）;COX-2在40例子宫颈腺癌组织阳性率82．5％（33／40）,高于慢性子宫颈炎患者子宫颈组织阳性率0（0／30）,差异有统计学意义（x^2=46．16,P〈0．05）;ARHI蛋白阳性表达率与子宫颈腺癌临床分期（x^2=3．96,P〈0．05）及组织分化程度高低有关（x^2=7．04,P〈0．05）。COX-2蛋白与子宫颈腺癌组织分化程度有关（x^2=7．04,P〈0．05）,与临床分期无关（P〉0．05）;ARHI蛋白和COX-2蛋白与淋巴结有无转移均无关（P均〉0．05）;ARHI蛋白和COX．2蛋白表达有关联（r=0．31,P〈0．05）。结论子宫颈腺癌的发生与ARHI基因失活和COX-2蛋白表达异常有关,两者可能协同作用参与子宫颈腺癌的发生。     

Statistical Modelling and Forecasting of Cervix Cancer Casesin Radiation Oncology Treatment: A Hospital Based Studyfrom Western Nepal

Background: To estimate the numbers and trends in cervix cancer cases visiting the Radiotherapy Departmentat Manipal Teaching Hospital, Pokhara, Nepal, statistical modelling from retrospective data was applied.Materials and Methods: A retrospective study was carried out on data for a total of 159 patients treated forcervix cancer at Manipal Teaching Hospital, Pokhara, Nepal, between 28th September 2000 and 31st December2008. Theoretical statistics were used for statistical modelling and forecasting. Results: Using curve fittingmethod, Linear, Logarithmic, Inverse, Quadratic, Cubic, Compound, Power and Exponential growth modelswere validated. Including the constant term, none of the models fit the data well. Excluding the constant term, thecubic model demonstrated the best fit, with R2=0.871 (p=0.004). In 2008, the observed and estimated numbers ofcases were same (12). According to our model, 273 patients with cervical cancer are expected to visit the hospitalin 2015. Conclusions: Our data predict a significant increase in cervical cancer cases in this region in the nearfuture. This observation suggests the need for more focus and resource allocation on cervical cancer screeningand treatment.     

Follow-Up Consultations for Cervical Cancer Patients in a Mexican Cancer Center. Comparison with NCCN Guidelines.

Purpose: This study aimed to determine the patterns of follow-up visits for cervix cancer in a national cancercenter in Mexico. Materials and Methods: The National Cancer Institute of Mexico is cancer center with 119beds that mostly cares for an underserved and socially disadvantaged population. The medical records of casesof cervical cancer that had at least one year of clinical follow-up after being in complete response at the endof primary treatment were analyzed. We recorded the numbers of total and yearly follow-up visits and thesewere compared with the number of follow-up visits recommended by the National Comprehensive CancerNetwork 2013, version 2 for cervical cancer. Results: Between March and June 2007, the medical records of 96consecutive patients were reviewed. Twenty (21%) of these met inclusion criteria and were selected. In the firstyear the median number of visits was 11 (4-20). In the ensuing years, 2nd, 3rd, 4th and 5th, the number of analyzedpatients remaining in follow-up decreased to 17, 14, 13 and 9 respectively. There were 462 follow-up visits toprimary treating services (Gynecology Oncology, Radiation Oncology and Medical Oncology) as compared to220 suggested by the NCCN guidelines (X2 test p<0.0001). There were 150 additional visits to other services.Conclusions: Our results suggest that in our institution there is an overuse of oncological services by cervicalcancer patients once treatment is completed.     

血管扩张刺激磷蛋白与微管蛋白的结合

目的 探讨血管扩张刺激磷蛋白(VASP)及其丝氨酸157(p-VASP S157)和239(p-VASP S239)位点磷酸化与α 微管蛋白(α-Tubulin) 之间的关系,明确VASP是一个新的微管相关蛋白。方法 采用免疫荧光染色观察p-VASP S157、 p-VASP S239和α-Tubulin在人宫颈癌上皮细胞HeLa的共定位; 利用免疫共沉淀、微管沉淀和Western blot方法明确VASP及其不同位点磷酸化与α-Tubulin的结合情况。结果 VASP和p-VASP S157能够与α Tubulin结合; p-VASP S239在细胞周期各个时期与α-Tubulin均无共定位关系。结论 VASP是一个新的微管相关蛋白,其丝氨酸157磷酸化与二者的结合相关。