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1.
《Asian Pacific journal of cancer prevention》2009,10(6):969-974
Cervical cancer is the second most common cancer among women in the world. Despite a decline of up to70% in its incidence and prevalence through screening programs, it is still the most common gynecologicalcancer worldwide. Since the human papilloma virus (HPV) was conclusively identified as the etiological factorinducing cervical cancer, investigations during the last two decades have been concentrating on producing avaccine against HPV virus. Thus prevention of HPV infection has been the main purpose and vaccination isexpected to reduce up to 70% of related cervical cancer and prevent precancerous and cancerous lesions of thegenitalia. However, screening programs are still essential for those who have already been exposed to the highrisk forms of the virus and educational and information programs continue to play important roles to increasethe success rate of screening, by whichever of the modalities is most appropriate for the local conditions. 相似文献
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《Asian Pacific journal of cancer prevention》2006,7(4):683-686
Cancer of the cervix is the second most common life-threatening cancer among women worldwide and bothincidence and mortality rates are likely to be underestimated in developing countries. HPV high risk strains play atleast the major if not an absolutely necessary role in the etiology. The concept of cervical intraepithelial neoplasia(CIN) was introduced in 1968 as an equivalent to the term dysplasia, which means abnormal maturation. Cervicalcancer progresses slowly from preinvasive CIN to invasive cancer and therefore screening for dysplasia is an importantpublic health effort worldwide, given the accessibility of the primary organ site, the acceptability of current screeningmethods, and the long preinvasive period in which to detect disease and successfully intervene. It is widely acceptedthat detection and treatment of HPV-related dysplastic epithelial change in the form of CIN-2 and CIN-3 canprevent the development of invasive cervical cancer in individual patients. The mainstay of screening programs hasbeen the Pap smear, introduced originally by George Papanicolaou in 1941. However, considerable numbers of falsenegativePap smears may occur with the traditional Pap technique, mostly due to sampling error. More recently, theuse of liquid-based technologies such as ThinPrep and AutoCyte Prep have gained popularity, in part because ofevidence suggesting reduction in the incidence of inadequate smears. It is also hoped that the ability to identifypatients with oncogenic HPV types will lead to improved detection in women more likely to have squamousintraepithelial lesions. Hybrid Capture 2 is the latest refinement of HPV tests and has been described as havingenhanced sensitivity. HPV DNA testing can be used as an adjunct to cytology in routine cervical disease screeningprograms. Establishment of the link between HPV and cervical cancer has further provided the impetus for researchinto prophylactic vaccination against the most common HPV types associated with the disease, HPV 16 and 18.Initial studies have provided evidence that L1 virus-like particle vaccines against HPV types (as monovalent, bivalent,or quadrivalent vaccines) prevent at least 90% of incident and persistent infections and their associated precursorsof cervical cancer. This vaccine has sustained long-term vaccine efficacy against incident and persistent infectionsand in the long term should provide an answer to the cervical cancer problem. For the vast majority of women whohave already been infected, however, continued screening and resection need to be emphasized. 相似文献
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《Asian Pacific journal of cancer prevention》2013,14(1):503-506
Objectives: To determine human papillomavirus (HPV) frequency, genotypes and the relation betweencervical smear results, risk factors and types in women living in Manisa, Turkey. Materials and Methods: A totalof 410 women were included in the study. Cervical specimens were obtained for linear array HPV genotypingand pathological testing. Conventional Pap test and Bethesda system were used for evaluation of cytologyspecimens. Results: A total of 410 women with a mean age of 34.9 years were tested. A positive result of anyHPV was found in 35 patients (8.5%). Among them, 26 different serotypes of HPV were identified and the mostfrequent type was HPV 16 (28.5%) followed by type 45 and 53 (11.4%). Patients were infected by 65.7% highrisk, 11.4% probable high risk and 22.9% low risk HPV types. Multiple HPV positive results were found in13 patients (37.1%). Patients with single partner, history of abnormal smear or condyloma had positive HPVresults and this was statistically significant (p<0.05). Correlation analysis showed a statistically weak relationbetween positive HPV and abnormal smear results (r=0.120). Conclusions: Determining HPV types of genitalHPV infections is important for epidemiological studies. We have found the rate of positive HPV as 8.5% whichimplies the need for extended screening programs in order to diagnose oncogenic HPV at an early stage. 相似文献
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Aidy Irman YajidMohd Azali ZakariahAnani Aila Mat ZinNor Hayati Othman 《Asian Pacific journal of cancer prevention》2017,18(2):315-319
In 2006, cervical cancer was reported as the second most common cancer in women of Malaysia. This type of cancer has been shown to correlate with persistent high risk human papillomavirus (HPV) infection. Although HPV is well known to induce cervical cancer, knowledge of pathways that link the latent stage of the viral replication cycle to precancerous and cancerous stages remains incomplete. However, it is interesting to note that the virus can be isolated from tissues ranging from normal to low-grade squamous intraepithelial lesions as well as high-grade intraepithelial lesions (HSILs), thus prompting scientists to develop HPV detection methods for screening. Detection of HPV using viral proteins such as L1 and E1 is proposed to be very useful in assisting the management of high risk infection and cervical cancer. These tests however can lead to false positive results, largely due to the exisstence of asymptomatic or transient HPV infections within any given individual. Somes observation indicate that use of HPV proteins such as E6 and E7 might lead to false positive results. However, one particular HPV protein, E4 shows potential as an accurate marker of the tissue state following HPV infection. E4 expression has been shown to correlate with the levels of HPV DNA incorporation by the host. Thus, it is possible that E4 could serve as a useful marker to define stages of viral carcinogenesis. 相似文献
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《Asian Pacific journal of cancer prevention》2009,10(5):747-752
Objectives: Many developing countries, including Malaysia, will need to continue relying on cervical screeningbecause they will not be able to cover their entire female adolescent populations with HPV vaccination. The aimof this paper was to establish the extent of the health care, informational, financial and psychosocial barriers tocervical screening in Malaysia. Methods: A literature search was made for reports on implementation, perceptionsand reception of cervical screening in Malaysia published between January 2000 and September 2008. Results:Despite offering Pap smears for free since 1995, only 47.3% of Malaysian women have been screened. Severalfactors may have contributed to this. No national call-recall system has been established. Women are informedabout cervical screening primarily through mass media rather than being individually invited. Smears are freeof charge if taken in public hospitals and clinics, but the waiting times are often long. The health care system isunequally dense, with rural states being underserved compared to their urban counterparts. If the screeningcoverage was to increase, a shortage of smear-readers would become increasingly apparent. Conclusions:Improving screening coverage will remain an important strategy for combating cervical cancer in Malaysia.The focus should be on the policy-making context, improving awareness and the screening infrastructure, andmaking the service better accessible to women. 相似文献
6.
《Asian Pacific journal of cancer prevention》2016,17(2):625-630
Background: Despite the established role of the Pap smear test (PST) in prevention and early detection of cervical cancer, it is still rarely practiced in Sudan. Many challenges hinder the establishment of an effective cervical cancer screening program, including socio-cultural factors. Therefore, this study aimed to investigate the knowledge, attitudes and practices (KAP) of Sudanese women with regard to the Pap smear test and cervical cancer. Materials and Methods: A total of 500 married women aged 14 to 58 years were recruited from obstetric clinics, hospitals and universities in Khartoum in 2014. Data were collected using a standardized, pretested questionnaire that inquired socio-demographic characteristics and their KAP about cervical cancer and the PST. Results: More than 52% of participating women were above 30 years of age, and the majority (78.8%) were university degree holders. A total of 486 (97.2 %) of participants were resident in urban areas of Khartoum State. However about 48% of the respondents had never heard about PST, and only 15.8% of the participants had undergone a Pap smear test previously; 46.6% (233/500) knew that the human papilloma virus (HPV) was the causative agent, but only 39.2% (196/500) had heard about HPV vaccination, and only 11.4% (57/500) had received the vaccine. However 68% of the respondents agreed to do Pap smear if properly informed about the test and 75.4% of the respondents agreed to participate in a cervical cancer screening program. Conclusions: Despite a high educational level, less than half of our participants had accurate knowledge about cervical cancer, HPV, and cervical cancer screening. Health education about cervical cancer, HPV and sexually transmitted infections and the role of PST in cervical cancer prevention are crucial when designing interventions aimed at improving cervical cancer screening for Sudanese women. 相似文献
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鉴于人乳头瘤病毒（HPV）与人类宫颈上皮内瘤样病变以至宫颈癌的发病有密切的关系,为此作者复习相关文献,就HPV的结构、女性生殖道HPV感染的流行病学、HPV感染与宫颈癌的关系等方面加以扼要的综述。 相似文献
9.
HPV在宫颈病变中的临床意义 总被引：12，自引：0，他引：12
生殖道人乳头瘤病毒(HPV)感染是一种广泛流行的性传播疾病.高危型HPV持续感染被认为是宫颈癌及其癌前病变发生的主要因素.多重HPV感染、HPV病毒负荷与宫颈癌及其癌前病变的病变程度及发展密切相关.目前,对于宫颈HPV感染检测有多种手段,其中PCR和捕获杂交技术(HCⅡ)在临床实验室应用较广泛.在宫颈癌的筛查中联合应用HPV检测和细胞学,可以提高敏感性、减少随诊频率,减少不必要的阴道镜检查.对于细胞学检查为不典型鳞状细胞(ASCUS)者,HPV检测可以帮助进一步区分高危人群.同时,HPV检测有可能作为一种有效的宫颈癌前病变及宫颈癌治疗后随访的预后指标. 相似文献
10.
Farjadian S Asadi E Doroudchi M Dehaghani AS Tabei SZ Kumar VP Ghaderi A 《Pathology oncology research : POR》2003,9(2):121-125
This study was undertaken to assess the rate of HPV infection in cervical carcinoma among southern Iranian patients. 101 archival cervical carcinoma tissue samples of a 10 year period were studied for the presence of HPV DNA in southern Iran by a polymerase chain reaction method. In addition, the presence of high risk HPV-16 and HPV-18 genotypes was investigated. In total, 88 (87.1%) of the samples were HPV DNA positive, of which 83 were squamous cell carcinomas and 5 were adenocarcinomas. HPV-16 genotype was detected in 26.7% of HPV positive cervical carcinomas; however, none of the samples were positive for the existence of HPV-18 genotype. Collectively, these results suggest that HPV-16 and HPV-18 are not the frequent high risk HPV types in our patients and circulating HPV types in southern Iranian population are different from many other populations. 相似文献
11.
人乳头瘤病毒变异株与宫颈疾病 总被引：1，自引：0，他引：1
人乳头瘤病毒(HPV)感染是发生宫颈癌的必要条件。根据病毒基因组核苷酸序列,在亚型的基础上可以进一步将HPV分为不同的变异株。HPV变异株的分布与地理位置关系密切。某些特定的HPV变异株感染可能增加发生宫颈癌的风险,其可能的机制是免疫逃逸、改变病毒癌基因的表达等。 相似文献
12.
Zhang HY Tiggelaar SM Sahasrabuddhe VV Smith JS Jiang CQ Mei RB Wang XG Li ZA Qiao YL 《Asian Pacific journal of cancer prevention》2012,13(1):91-96
Objectives: To determine the prevalence of HPV and cervical neoplasia among HIV-infected women insouthwestern China. Methods: Cervical cytology, HPV detection by Hybrid Capture-2™ assay, and diagnosticcolposcopy were followed by cervical biopsy if indicated. Logistic regression analysis was used to analyzeassociations between HPV co-infection and cervical intraepithelial neoplasia (CIN), and HIV-related clinicaland laboratory parameters. Results: Colposcopic-histopathologically proven CIN2+ lesions were present in7/83 (8.4%) HIV-infected women. Nearly half (41/83, 43%) were co-infected with carcinogenic HPV genotypes.HPV co-infection was higher in women with colposcopic-histopathologically proven CIN2+ lesions than womenwith 相似文献
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HPV and cervical cancer: screening or vaccination? 总被引：2，自引：0，他引：2
Following the demonstration of the superior validity of human papillomavirus (HPV) tests in screening for cervical cancer and the arrival of highly efficacious HPV 16 and 18 vaccines, cervical cancer prevention enters a time of sustainable introduction in developing countries. Multidisciplinary efforts and novel protocols are being developed, and challenging situations are being faced to make cervical cancer, still the number two cancer in women worldwide, an eradicable condition. 相似文献
15.
Hibbitts S Rieck GC Hart K Powell NG Beukenholdt R Dallimore N McRea J Hauke A Tristram A Fiander AN 《British journal of cancer》2006,95(2):226-232
The objective of this study was to describe human papillomavirus (HPV) prevalence in South Wales in relation to age, cytology and social deprivation. This was an unlinked, prospective, anonymous, population-based study. DNA was purified from 1911 liquid-based cytology samples (mean age 37.7 years, cytology 93.2% negative, social deprivation average score 17.9) using quality assured techniques and the presence of virus determined by PCR-Enzyme Immuno Assay (PCR-EIA). 209 (10.9%) samples contained high-risk (HR) HPV infection of which 36.4% had multiple HR-HPV types. The most frequent HR types were HPV 16 (19.6%), HPV 35 (9.5%), HPV 66 (9.2%), HPV 59 (8.5%) and HPV 56 (7.6%). There was a strong association between HPV infection and cytological abnormality. Significantly more HR-HPV infections were detected in women under the age of 30 years (68.9% of all HR-HPV infections Fisher's exact test P=0.0001) compared to 30 years and above. There was no difference in HPV prevalence between different socioeconomic groups. The data presented suggest a different HPV type distribution in South Wales in comparison to that reported for other populations. 相似文献
16.
《Asian Pacific journal of cancer prevention》2014,15(23):10053-10056
The human papilloma virus (HPV) is the main aetiological agent for cervical cancer, one of the most frequentcancers observed in women throughout the world. There are effective programs for reducing the incidence ofcervical cancer with HPV vaccination. The objective of this study was to discuss the applicability of the HPVvaccination and the role of nurses in prevention of cervical cancer. Use of bivalent and quadrivalent vaccineshas been initiated against the types of HPV which are the primary cause of cancer. The quadrivalent HPVvaccination has entered into the routine vaccination schedule in many European countries for use in children andadolescents between 9-15 years of age and for women between 16-26 years of age, whereas it has been proposedthat the bivalent vaccination should be given to girls between 9-18 years of age. While cervical cancer is amongthe cancers that can be prevented, it is essential to continue screening tests while introducing vaccination in asystematic manner for protection. On this subject, among the most important roles of nurses is to implementthe screening programs by fulfilling the caregiving, training and consultancy roles for the society and especially,for high risk groups and to increase the awareness of the people. 相似文献
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目的：了解妇瘤科门诊患者对高危型人乳头瘤病毒（HPV）疫苗的知晓情况及接受程度。方法采用问卷调查方式对588例门诊患者进行面对面调查。调查对象包括因宫颈因素就诊的患者（HPV感染、宫颈涂片异常、宫颈上皮内瘤变、宫颈癌等）。结果研究调查了588例门诊患者,因9份问卷不完整,最终共分析579份调查问卷。调查对象平均年龄（36.91±10.1）岁。其中只有108例（18.7%）患者听说过HPV疫苗,然而73.7%（427/579）的被调查者愿意接受HPV疫苗。在进行多因素分析后,年龄小于﹤30岁、教育水平为大专及以上、因宫颈因素就诊为门诊患者对HPV知晓率的独立影响因素。调查中40.7%的患者有关HPV疫苗的信息主要来自网络,54.9%的调查对象希望以后能够通过医生更多地了解HPV疫苗。结论门诊患者对HPV疫苗的知晓程度较低,但仍有73.7%的患者愿意接受HPV疫苗。为了更好地开展HPV疫苗接种计划以及控制宫颈癌的发生,在医师诊疗工作中可以增加HPV疫苗宣教的内容。 相似文献
20.
Human papillomavirus testing in primary screening for the detection of high-grade cervical lesions: a study of 7932 women 总被引：27，自引：0，他引：27
Clavel C Masure M Bory JP Putaud I Mangeonjean C Lorenzato M Nazeyrollas P Gabriel R Quereux C Birembaut P 《British journal of cancer》2001,84(12):1616-1623
High-risk human papillomaviruses (HR-HPV) are the necessary cause of cervical carcinomas. To determine whether HPR-HPV DNA detection in primary routine screening could represent a sensitive and reliable technique for the detection of high-grade squamous intraepithelial lesions (HGSIL), laboratory analysis using 2 cytologic techniques (conventional and liquid-based), HPV testing with Hybrid Capture II assay (HC-II), followed by colposcopic examination of women with abnormal cervical finding and/or persistent HR-HPV infection, was conducted in 7932 women who had routine cervical examination. The sensitivity of HPV testing for detecting a histologically proven HGSIL was 100%, higher than that of conventional (68.1%) and liquid-based (87.8%) cytology. The low specificities of 85.6% and 87.3% of HPV testing slightly increased to 88.4% and 90.1% if HPV testing was reserved for woman >30 years old. The quantitative approach provided by the HC-II assay for the assessment of the viral load was not reliable for predicting HGSIL in normal smears. HR-HPV testing could be proposed in primary screening in association with cytology. With conventional cytology it significantly improves the detection of HGSIL. With the use of the same cervical scrape for HPV testing and liquid-based cytology, HR-HPV testing would allow to select positive samples treated in a second time for cytology which gives a good specificity. 相似文献
