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中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程 相似文献
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目的 评估宫颈癌筛查中非典型鳞状细胞(ASC-US)但人乳头瘤病毒(HPV)阴性的妇女罹患中度及以上宫颈上皮内瘤样病变(CIN2+)的风险。方法 汇总1999-2008年在我国开展的17项以人群为基础的宫颈癌筛查横断面研究,共30371名17~59岁妇女参加筛查,所有妇女均进行了液基细胞学检查(LBC)、HPV检测(hybrid capture 2, HC2)和醋酸染色肉眼观察法(VIA),任一结果阳性者转诊阴道镜。最终28810名具有完整细胞学、HPV、病理检测结果的妇女纳入分析,分别以细胞学正常且HPV阴性组(LBC-/HPV-)、细胞学正常组(LBC-)为参照,评估细胞学为ASC-US且HPV阴性组(ASC-US/HPV-)的CIN2+患病风险。结果 LBC-/HPV-、LBC-和ASC-US/HPV-组分别有22003、24139和1834名妇女,CIN2+的患病率分别为0.05%、0.36%和0.16%。分别以LBC-/HPV-组、LBC-组为参照,ASC-US/HPV-组罹患CIN2+的风险分别为3.00(95%CI:0.85~10.65)和0.46(95%CI:0.15~1.45),其校正OR值分别为4.00(95%CI:1.08~14.87)、0.47(95%CI:0.15~1.49)。结论 ASC-US/HPV-妇女CIN2+的患病风险介于LBC-和LBC-/HPV-妇女之间。依据"同等风险、同等管理"的原则,可采用对LBC-者的3年筛查间隔,而对于卫生资源相对匮乏地区可采用对LBC-/HPV-者的5年筛查间隔。 相似文献
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Yan Wang Ying-Bin Cai William James Jian-Lin Zhou Remila Rezhake Qian Zhang 《中华医学杂志(英文版)》2021,134(15):1838
Background:Cervical cancer remains a major public health issue for the Uyghur women and other women living mainly in rural areas of Xinjiang. This study aims to investigate the distribution of human papillomavirus (HPV) infection and cervical cancer in rural areas of Xinjiang, China.Methods:Cervical cancer screening was performed on rural women aged 35 to 64 years from Xinjiang, China in 2017 through gynecological examination, vaginal discharge smear microscopy, cytology, and HPV testing. If necessary, colposcopy and biopsy were performed on women with suspicious or abnormal screening results.Results:Of the 216,754 women screened, 15,518 received HPV testing. The HPV-positive rate was 6.75% (1047/15,518). Compared with the age 35–44 years group, the odds ratios (ORs) of HPV positivity in the age 45–54 years and 55–64 years groups were 1.18 (95% confidence interval [CI]: 1.02–1.37) and 1.84 (95% CI: 1.53–2.21), respectively. Compared with women with primary or lower education level, the ORs for HPV infection rates of women with high school and college education or above were 1.37 (95% CI: 1.09–1.72) and 1.62 (95% CI: 1.23–2.12), respectively. Uyghur women were less likely to have HPV infection than Han women, with an OR (95% CI) of 0.78 (0.61–0.99). The most prevalent HPV types among Xinjiang women were HPV 16 (24.00%), HPV 33 (12.70%), and HPV 52 (11.80%). The detection rate of cervical intraepithelial neoplasia (CIN)2+ was 0.14% and the early diagnosis rate of cervical cancer was 85.91%. The detection rates of vaginitis and cervicitis were 19.28% and 21.32%, respectively.Conclusions:The HPV infection rate in Xinjiang is low, but the detection rate of cervical cancer and precancerous lesions is higher than the national average level. Cervical cancer is a prominent public health problem in Xinjiang, especially in southern Xinjiang. 相似文献
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目的 评价我国汉族和蒙古族女性自然人群及不同宫颈病变级别中的高危人乳头瘤病毒型别分布及感染状况,为不同民族宫颈癌筛查和疫苗防控策略的制定提供理论依据。方法 2017年6月在我国山西省襄垣县、阳城县和内蒙古自治区鄂托克旗3个农村地区开展以人群为基础的多中心宫颈癌筛查研究,共纳入研究对象9 517名。所有研究对象均通过自我采样方法采集2份宫颈阴道分泌物标本,分别进行careHPV及PCR HPV检测(不分型),并对任意阳性标本进行基于PCR方法的HPV分型检测。上述两种方法任意阳性者转诊阴道镜,阴道镜下若有病变于病变处直接活检,阴道镜下不满意者行宫颈管搔刮术。病理结果作为最终疾病诊断金标准。结果 汉族女性HPV感染者1 842人(21.83%),蒙古族女性HPV感染者269人(24.93%),两个民族HPV感染率差异有统计学意义(χ2=5.328,P=0.021)。蒙古族女性宫颈上皮内瘤样变1级的检出率[2.83%(30/1 059)]高于汉族女性[0.87%(73/8 378)],差异有统计学意义(χ2=33.509,P<0.001),但宫颈上皮内瘤样变2级及以上的检出率差异无统计学意义[蒙古族:1.04%(11/1 059);汉族:0.95%(80/8 378),χ2=0.069,P=0.793]。两民族宫颈上皮内瘤样变2级及以上女性HR-HPV型别分布排在前三位的均是HPV16、52、58型。汉族和蒙古族女性多重感染率分别为41.37%、44.35%,两民族间差异无统计学意义(χ2=0.764,P=0.382)。结论 蒙古族女性的HPV感染率高于汉族女性,对汉族和蒙古族女性进行宫颈癌的综合防控时,应提高对HPV16、52、58型的重视。 相似文献
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Remila Rezhake Shang-Ying Hu Yu-Qian Zhao Li Zhang Xue-Lian Zhao Ayling Z. Dominguez You-Lin Qiao Cai-Hong Zhou Fang-Hui Zhao 《Journal of cancer education》2018,33(3):511-516
International collaborative training programs for graduate students are widespread, but studies on their educational impact are limited. As an advanced cancer institute in China, Cancer Hospital Chinese Academy of Medical Science (CHCAMS) attaches great importance to international exchanges and cooperation within graduate education. The Department of Epidemiology of CHCAMS has been involved in several existing international training programs and has also launched a short-term training program in cooperation with foreign universities and institutes from 2008. Fogarty International Clinical Research Scholars and Fellows (FICRS-F) Program and the Fulbright-Fogarty Fellowship Program are the most typical examples of our practice in international cooperation on graduate education over these years. Our department has gained substantial experience in graduate-level international collaborative training, focused on cancer epidemiology. This paper is a brief introduction to the practice of different programs in our department and students’ achievements during and after training. Moreover, we attempt to serve as a reference and help promote the training of graduate students pursuing careers in cancer research or global health by other universities or research institutes. 相似文献
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Shang-Ying Hu Rezhake Remila Qian Zhang Li Dong Li Zhang Rui-Mei Feng Xue-Lian Zhao Feng Chen Xun Zhang Qin-Jing Pan Wen-Hua Zhang Jun-Fei Ma You-Lin Qiao Fang-Hui Zhao 《Lancet》2017
Background
The long-term risk of progression or regression in women with biopsy-confirmed normal cervical epithelium or cervical intraepithelial neoplasia grade 1 (CIN1) is unclear. The aim of the study was to assess the rates of progression and regression of women with histological CIN1 or normal cervical epithelium in rural China.Methods
A screening cohort for cervical cancer was built in 1999 in Xiangyuan County, Shanxi Province, with a sample size of 1997 women aged 35–45 years, who were followed up in 2005 (6-year follow-up), 2010 (11-year follow-up), and 2014 (15-year follow-up) with human papillomavirus (HPV) DNA testing, liquid-based cytology, and visual inspection with acetic acid (except in 2014). Progression and regression rates of histological normal and CIN1 at different follow-up timepoints were calculated stratified by baseline HPV status.Findings
The cumulative rate of progression to CIN2+ among women who were CIN1 baseline was 7% (8/107) at 6-year follow-up, 21% (22/103) at 11-year follow-up, and 24% (23/96) at 15-year follow-up. Women who were CIN1 and HPV-positive had significantly higher progression rates (13% [8/63] at 6 years, 33% [20/60] at 11 years, and 36% [21/59] at 15 years) than did those who were CIN1 but were negative for HPV (0% [0/44], 5% [2/43], and 5% [2/37], respectively; p=0·014 at 6 years, p=0·0005 at 11 years, and p=0·0007 at 15 years). Meanwhile, up to 95% of women who were CIN1 and HPV negative at baseline regressed to normal during the 15-year period. Furthermore, the rates of progression to CIN2+ among women who were histologically normal was 1% (11/1543) at 6-year follow-up, 3% (40/1358) at 11-year follow-up, and 5% (60/1162) at 15-year follow-up; more than 90% of women maintained at normal during the 15-year period.Interpretation
HPV testing could be helpful to monitor women with CIN1 or normal cervical epithelium. The screening interval for those without HPV infection could be safely extended to 5–10 years, but those who are HPV-positive should be followed closely.Funding
National Natural Science Foundation of China (grant number 81050018, 81322040, 81402748); Chinese Academy of Medical Science Initiative for Innovative Medicine (2016-I2M-1-019). 相似文献9.
Remila Rezhake Feng Chen Shang-Ying Hu Xue-Lian Zhao Xun Zhang Jian Cao You-Lin Qiao Fang-Hui Zhao Marc Arbyn 《International journal of cancer. Journal international du cancer》2020,147(8):2053-2064
Improvement in managing HPV-positive women is urgently needed. Based on a population-based study which included 2112 women aged 49 to 69 from Shanxi, China, we aimed to evaluate the clinical performance of multiple triage strategies based on liquid-based cytology (LBC), p16INK4a, viral load and partial genotyping, as a single or combined strategy for detecting cervical intraepithelial neoplasia grade 2/3 or higher (CIN2+/CIN3+) in women who tested positive by Hybrid Capture 2 (HC2). Among 452 HC2-positive women, the test positivity of LBC (ASC-US+), p16INK4a, HPV16/18 and HPV16/18/31/33/45 were 39.6%, 38.5%, 18.0% and 40.0%, respectively. Compared to LBC (ASC-US+) triage, a single triage strategies using p16INK4a or extended genotyping (SureX HPV16/18/31/33/45) achieved comparable sensitivity (relative sensitivity: 1.08, 95% confidence interval [CI]: 0.93-1.26 and 0.96, 95% CI: 0.76-1.22) and specificity (relative specificity: 1.05, 95% CI: 0.96-1.14 and 1.02, 95% CI: 0.92-1.14) for CIN3+. Viral load triage using a ≥50 RLU/CO cut-point also yielded similar results with LBC (ASC-US+). Among combined triage strategies, HPV16/18 genotyping with reflex p16INK4a showed higher sensitivity and slightly lower specificity than LBC (ASC-US+) for CIN3+ detection, however, the differences were not statistically significant. Of note, after a negative result by p16INK4a or LBC among HPV16/18 negative women, the posttest probability of CIN3+ was lower than 1%. Our study suggested that p16INK4a, extended genotyping and increased viral load cut-point could be promising alternatives to cytology triage. Combined triage algorithms of HPV16/18 with reflex p16INK4a or cytology, if negative, are associated with the substantial low posttest risk sufficient to release women to next screening round. 相似文献
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我国宫颈癌的疾病负担较重,其发病率和死亡率呈逐年升高且年轻化趋势,防控形势较为严峻,急需探索适宜我国不同资源地区的、新型的早诊早治手段,以加快我国宫颈癌的防治步伐。近些年人工智能(AI)在图像分类领域取得较大进展,科学家们开发出众多能够识别宫颈病变的算法,并对其准确性进行了相应的研究。本文结合国内外研究成果,就AI在宫颈细胞学筛查、阴道镜、宫颈恶性肿瘤的诊断及治疗预测过程等方面的应用进展进行综述,并探讨AI在宫颈病变诊断及治疗中遇到的挑战,使AI协助医疗工作者更好地为人类健康保驾护航。 相似文献