1
|
Sabihi S, Vahedpoor Z, Saraf-Bank S, Nourian M. Effects of folate supplementation on recurrence and metabolic status of cervical intraepithelial neoplasia grade 2/3 in overweight and obese women: a randomized double-blind placebo-controlled trial. Eur J Clin Nutr 2022; 76:666-670. [PMID: 35383339 DOI: 10.1038/s41430-021-01022-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/17/2021] [Accepted: 09/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVE Inconsistent evidence showed that folate supplementation may be associated with reduced risk of cancer due to improved metabolic profiles and reduced markers of oxidative stress and inflammation. The aim of this investigation was to quantify the effects of folate supplementation on the recurrence and other metabolic factors of women with cervical intraepithelial neoplasia grade 2/3 (CIN2/3). METHODS This randomized, double-blind, placebo-controlled clinical trial was performed among 60 overweight/obese women with CIN2/3. Definitive CIN2/3 confirmation was done via biopsy, pathological diagnosis, as well as colposcopy. Participants were randomly assigned to the intervention group to take 5 mg/day folate supplements or placebo group (n = 30 in each group) for 12 weeks. RESULTS The results of the current study showed a non-significant decrease in recurrence of CIN2/3 in the folate group in comparison with the placebo group (3.3% vs. 16.7%, P = 0.08). Compared with the placebo, folate supplementation significantly decreased plasma homocysteine (Hcy) levels (P < 0.001), serum insulin values (in the crude model) (P = 0.01), and homeostasis model assessment of insulin resistance (P = 0.01). Also, folate supplementation resulted in a significant improvement in the quantitative insulin sensitivity check index (P = 0.002) and total antioxidant capacity (P = 0.04) and a significant reduction in high-sensitivity C-reactive protein (P = 0.015) in comparison with the placebo group. CONCLUSIONS In conclusion, folate supplementation for 12 weeks among overweight/obese women with CIN2/3 showed a non-significant decrease in its recurrence and had beneficial effects on insulin sensitivity, inflammation, and oxidative stress markers.
Collapse
Affiliation(s)
- Sima Sabihi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Vahedpoor
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, IR, Iran
| | - Sahar Saraf-Bank
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Nourian
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. .,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
2
|
Karimi-Zarchi M, Allahqoli L, Nehmati A, Kashi AM, Taghipour-Zahir S, Alkatout I. Can the prophylactic quadrivalent HPV vaccine be used as a therapeutic agent in women with CIN? A randomized trial. BMC Public Health 2020; 20:274. [PMID: 32106837 PMCID: PMC7045378 DOI: 10.1186/s12889-020-8371-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/18/2020] [Indexed: 12/14/2022] Open
Abstract
Background Human papillomavirus (HPV) is one of the most significant risk factors for cervical cancer. The HPV vaccine has a very significant impact on the incidence of cervical cancer. The present study aimed to investigate the impact of prophylactic quadrivalent HPV vaccine in the treatment of women with cervical intraepithelial neoplasia (CIN 1–3). Methods This randomized controlled trial was conducted in the Shahid Sadoughi University of Medical Sciences (SSUMS), Yazd, Iran, from October 2011 to November 2015 in women with histologically confirmed residual/recurrent CIN 1 or high-grade CIN (CIN 2–3). Eligible women were assigned randomly to an intervention and a control group. Women in the intervention group were given HPV vaccinations while those in the control group were not. Participants were followed up for 24 months. Primary and secondary outcomes, and adverse effects of the treatment in the two groups were compared using Student’s t test, the chi-square test, or Fisher’s exact test. P values < 0.05 or less were considered statistically significant. Results Three-hundred and twelve women were randomized to the two groups; the data of 138 in the intervention group and 104 in the control group were analyzed. The mean age of the women was 32.59 ± 4.85 years. Differences in age, marital status, and grades of CIN weren’t significant between the two groups. At the end of the two-year follow-up period, the number of women with CIN 2–3 in the intervention and control groups was reduced by 75% (from 93 to 23) versus 40% (from 69 to 41). The efficacy of the HPV vaccine in women with CIN 1–3 was 58.7% (p = 0.018). No serious adverse effects related to the vaccines were reported. Conclusions The prophylactic quadrivalent HPV vaccine after treatment may have a therapeutic effect in women with residual/recurrent CIN 1 or high-grade CIN (CIN 2–3). Trial registration Iranian Registry of Clinical Trials, IRCT20190603043801N1. Registered 24 July 2019 – Retrospectively registered, http://www.irct.ir/user/trial/40017/view
Collapse
Affiliation(s)
- Mojgan Karimi-Zarchi
- Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.,Shahid Sadoughi University of Medical Science, Yazd, Iran
| | - Leila Allahqoli
- Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | | | | | | | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| |
Collapse
|
3
|
Vahedpoor Z, Mahmoodi S, Samimi M, Gilasi HR, Bahmani F, Soltani A, Sharifi Esfahani M, Asemi Z. Long-Term Vitamin D Supplementation and the Effects on Recurrence and Metabolic Status of Cervical Intraepithelial Neoplasia Grade 2 or 3: A Randomized, Double-Blind, Placebo-Controlled Trial. ANNALS OF NUTRITION AND METABOLISM 2018; 72:151-160. [PMID: 29466786 DOI: 10.1159/000487270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 01/28/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study was conducted to evaluate the effects of vitamin D supplementation on the recurrence and metabolic status of patients with cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3). METHODS This randomized, double-blind, placebo-controlled trial was carried out among 58 women diagnosed with CIN2/3. Participants were randomly assigned into 2 groups to receive either 50,000 IU vitamin D3 (n = 29) or placebo (n = 29) every 2 weeks for 6 months. RESULTS The recurrence rate of CIN1/2/3 was 18.5 and 48.1% in the vitamin D and placebo groups respectively (p = 0.02). When we excluded CIN1, the recurrence rate of CIN2/3 became nonsignificant. Vitamin D supplementation significantly decreased fasting plasma glucose (-7.8 ± 9.2 vs. -1.1 ± 8.6 mg/dL, p = 0.006) and insulin levels (-3.2 ± 4.8 vs. -0.9 ± 3.4 µIU/mL, p = 0.03), and significantly increased quantitative insulin sensitivity check index (0.01 ± 0.02 vs. 0.002 ± 0.01, p = 0.02) compared with the placebo. Additionally, there was a significant decrease in high-sensitivity C-reactive protein (-815.3 ± 1,786.2 vs. 717.5 ± 1,827.3 ng/mL, p = 0.002) and a significant increase in total antioxidant capacity (113.4 ± 137.4 vs. -53.7 ± 186.7 mmol/L, p < 0.001) following the supplementation of vitamin D compared with the placebo. CONCLUSIONS Vitamin D3 supplementation for 6 months among women with CIN2/3 had beneficial effects on CIN1/2/3 recurrence and metabolic status; however, it did not affect CIN2/3 recurrence.
Collapse
Affiliation(s)
- Zahra Vahedpoor
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Samaneh Mahmoodi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mansooreh Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Gilasi
- Department of Epidemiology and Biostatistics, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali Soltani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehran Sharifi Esfahani
- Department of Oncology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| |
Collapse
|
4
|
Xu L, Xu J, Hu Z, Yang B, Wang L, Lin X, Xia Z, Zhang Z, Zhu Y. Quantitative DNA methylation analysis of paired box gene 1 and LIM homeobox transcription factor 1 α genes in cervical cancer. Oncol Lett 2018. [PMID: 29541217 DOI: 10.3892/ol.2018.7872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
DNA methylation is associated with tumorigenesis and may act as a potential biomarker for detecting cervical cancer. The aim of the present study was to explore the methylation status of the paired box gene 1 (PAX1) and the LIM homeobox transcription factor 1 α (LMX1A) gene in a spectrum of cervical lesions in an Eastern Chinese population. This single-center study involved 121 patients who were divided into normal cervix (NC; n=28), low-grade squamous intraepithelial lesion (LSIL; n=32), high-grade squamous intraepithelial lesion (HSIL; n=34) and cervical squamous cell carcinoma (CSCC; n=27) groups, according to biopsy results. Following extraction and modification of the DNA, quantitative assessment of the PAX1 and LMX1A genes in exfoliated cells was performed using pyrosequencing analysis. Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity and specificity of each parameter and cut-off values of the percentage of methylation reference (PMR) for differentiation diagnosis. Analysis of variance was used to identify differences among groups. The PMR of the two genes was significantly higher in the HSIL and CSCC groups compared with that in the NC and LSIL groups (P<0.001). ROC curve analysis demonstrated that the sensitivity, specificity and accuracy for detection of CSCC were 0.790, 0.837 and 0.809, respectively, using PAX1; and 0.633, 0.357 and 0.893, respectively, using LMX1A. These results indicated that quantitative PAX1 methylation demonstrates potential for cervical cancer screening, while further investigation is required to determine the potential of LMX1A methylation.
Collapse
Affiliation(s)
- Ling Xu
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Jun Xu
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Zheng Hu
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Baohua Yang
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Lifeng Wang
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Xiao Lin
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Ziyin Xia
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Zhiling Zhang
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Yunheng Zhu
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| |
Collapse
|
5
|
Haghshenas MR, Mousavi T, Kheradmand M, Afshari M, Moosazadeh M. Efficacy of Human Papillomavirus L1 Protein Vaccines (Cervarix and Gardasil) in Reducing the Risk of Cervical Intraepithelial Neoplasia: A Meta-analysis. Int J Prev Med 2017; 8:44. [PMID: 28656100 PMCID: PMC5474905 DOI: 10.4103/ijpvm.ijpvm_413_16] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 02/06/2017] [Indexed: 01/21/2023] Open
Abstract
Human papillomavirus (HPV) can induce cervical intraepithelial neoplasia (CIN). Vaccination against HPV can play an important role in CIN prevention. This study aims to estimate the efficacy of L1 protein vaccines (Cervarix and Gardasil) in CIN 1, 2, 3 risk reduction using meta-analysis. Relevant articles were identified by two independent researchers searching international databanks. After application of inclusion/exclusion criteria and quality assessment, eligible articles were entered into the final meta-analysis. Inverse variance method and fixed effect model were used to combine the results of the primary studies. The heterogeneity between the results was assessed using Cochrane and I2 indices. Of 11,530 evidence identified during the primary search, three papers were found eligible for meta-analysis, including 7213 participants in the intervention groups and 7170 healthy controls. The efficacy (95% confidence interval) of HPV 6, 11, 16, 18 monovalent and quadrivalent vaccines against CIN 1, CIN 2, and CIN 3 were estimated as of 95% (88–98), 97% (85–99), and 95% (78–99), respectively. This study showed that L1 protein vaccines Cervarix and Gardasil are highly protective vaccines playing an effective role in the prevention of HPV 6, 11, 16, 18 which are responsible for CIN 1, CIN 2, and CIN 3.
Collapse
Affiliation(s)
- Mohammad Reza Haghshenas
- Department of Microbiology, Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahoora Mousavi
- Student Research Committee, Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Motahareh Kheradmand
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Afshari
- Department of Community Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
6
|
Lee H, Lee H, Cho YK. Cytokeratin7 and cytokeratin19 expression in high grade cervical intraepithelial neoplasm and squamous cell carcinoma and their possible association in cervical carcinogenesis. Diagn Pathol 2017; 12:18. [PMID: 28212672 PMCID: PMC5316189 DOI: 10.1186/s13000-017-0609-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 02/07/2017] [Indexed: 01/01/2023] Open
Abstract
Background High risk human papillomavirus (HR HPV) infects cells at the squamocolumnar junction (SCJ) of the cervix, causing cancer. Cytokeratin (CK)7 is an SCJ marker, and stains cervical neoplasia. CK19 is a binding partner of CK7 and expressed in cervical cancer. Despite this possible association between CK7/CK19 and cervical cancer, not much is known about the mechanism of CK7/CK19 involvement in HR HPV-mediated cervical carcinogenesis. Methods We analyzed the expression pattern of CK7, CK19, and p16 by using immunohistochemistry and HPV infection by in situ hybridization in 25 cases of high grade cervical intraepithelial neoplasia (CIN3) and in 30 cases of squamous cell carcinoma (SCC). Results CK19, p16, and HPV expression was positive in all CIN3 and SCC cases. CK7 expression was positive in all CIN3 cases and in 20/30 (66%) SCCs. Each protein showed diffuse or patchy staining with topographic distinction. Patchy staining of CK7 and episomal HPV DNA overlapped in the upper layer of CIN3 and central portion of an invasive nest in the SCC, whereas patchy CK19 staining and integrated HPV DNA were usually noted in the lower layer of CIN3 and the periphery of the SCC nest. The p16 staining pattern coincided with that of CK19 in a subset of SCC. Conclusion These results suggest that CK7 may be more related with viral episomal replication and CK19 with viral integration, contributing to viral replication and malignant transformation in HR HPV infected cells. In addition, coordinate CK7/CK19 staining may be used as a valuable marker for predicting physical status of HR HPV and E7 oncoprotein level in cervical tumor. Electronic supplementary material The online version of this article (doi:10.1186/s13000-017-0609-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hojung Lee
- Department of Pathology, Nowon Eulji Medical Center, Eulji University, 280-1 Hagye 1-dong, Nowon-gu, Seoul, 139-711, Korea
| | - Hyekyung Lee
- Department of Pathology, Daejeon Eulji Medical Center, Eulji University, 95 Dunsanseo-ro, Seo-gu, Daejeon, 35233, Korea
| | - Yong Kyun Cho
- Department of Internal Medicine, Division of Infectious Diseases, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Korea.
| |
Collapse
|
7
|
Clavero O, McCloskey J, Molina VM, Quirós B, Bravo IG, de Sanjosé S, Bosch FX, Pimenoff VN. Squamous intraepithelial lesions of the anal squamocolumnar junction: Histopathological classification and HPV genotyping. ACTA ACUST UNITED AC 2016; 3:11-17. [PMID: 28720443 PMCID: PMC5883205 DOI: 10.1016/j.pvr.2016.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 11/18/2016] [Accepted: 12/05/2016] [Indexed: 11/30/2022]
Abstract
Background Human papillomavirus (HPV)-related anal cancer lesions are often found adjacent to the squamocolumnar junction (SCJ). We have assessed the histopathology and associated HPV genotypes in anal SCJ lesions in surgically excised anal warts in HIV-negative and –positive patients. Methods Histopathology identified 47 squamous intraepithelial lesions (SILs) adjacent to the SCJ amongst a total of 145 cases of clinically diagnosed anal condylomata. The anal SCJ lesions were further analyzed with p16, CK7 and p63 immunohistochemistry and HPV genotyping. Results Sixteen (16/47) of the excised anal wart lesions contained HSIL; Three were HSIL and exclusively associated with oncogenic HPVs. A further thirteen (13/47) were mixed lesions. Of these eight were HSILs with LSIL and six were HSILs with papillary immature metaplasia (PIM); Ten of the mixed lesions were associated with one or more oncogenic HPVs, while three cases were exclusively associated with HPV6. Conclusions Clinically diagnosed anal warts cannot be assumed to be limited to low-grade lesions as anal warts of the SCJ often show heterogeneous lesions, with coexistence of LSIL, PIM, and HSIL. Lesions showing PIM, however, may mimic HSIL, because they are hypercellular, but lack the nuclear atypia and conspicuous mitotic activity of HSIL; and are p16 negative. Anal warts of the SCJ are often heterogeneous; with LSIL, including PIM and HSIL. Anal HSILs only with HPV6 may indicate that LR-HPVs have some role in oncogenesis. Recognition of PIM is important given its potential for being confused with HSIL. Clinical diagnosis of anal warts cannot be assumed to be limited to LSIL. Microscopic examination of anal warts is encouraged with appropriate immunostains.
Collapse
Affiliation(s)
- Omar Clavero
- Infections and Cancer Unit, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain; Hospital Quiron Salud, Barcelona, Spain
| | - Jenny McCloskey
- Sexual Health Clinic, Royal Perth Hospital, School of Laboratory and Pathology Medicine, University of WA, Perth, Australia
| | | | - Beatriz Quirós
- Infections and Cancer Unit, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Ignacio G Bravo
- Infections and Cancer Unit, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain; Bellvitge Institute of Biomedical Research (IDIBELL), Barcelona, Spain
| | - Silvia de Sanjosé
- Infections and Cancer Unit, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - F Xavier Bosch
- Infections and Cancer Unit, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Ville N Pimenoff
- Infections and Cancer Unit, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain; Bellvitge Institute of Biomedical Research (IDIBELL), Barcelona, Spain.
| |
Collapse
|
8
|
Al-Mandeel HM, Sagr E, Sait K, Latifah HM, Al-Obaid A, Al-Badawi IA, Alkushi AO, Salem H, Massoudi NS, Schunemann H, Mustafa RA, Brignardello-Petersen R. Clinical Practice Guidelines on the Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention in Saudi Arabia. Ann Saudi Med 2016; 36:313-320. [PMID: 27710981 PMCID: PMC6074318 DOI: 10.5144/0256-4947.2016.313] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Cervical cancer is the third most common gynecological malignancy in Saudi women with an estimated incidence rate of 1.9 cases per 100 000 women-years. More than 40% of cervical cancer cases are diagnosed at advanced stages due to lack of a routine screening program in Saudi Arabia. Thus, national guidelines for routine screening and treatment of precancerous cervical lesions are needed. METHODS The Saudi Centre for Evidence-Based Healthcare invited a panel of local experts and partnered them with a team from McMaster University in Canada for methodological support, to develop national clinical practice guidelines on the screening and treatment of precancerous lesions for cervical cancer. After the panel identified key clinical questions, the McMaster University working group updated existing systematic reviews that had been used for the 2013 WHO Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Recommendations were based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. Those recommendations took into account the available evidence, patient values and preferences, and resource use in the Saudi context. The panel provided recommendations on two major issues: screening for precancerous lesions (cervical intraepithelial neoplasia 2 & 3) and treatment of those lesions to prevent cervical cancer in women who tested positive after screening. CONCLUSIONS The Saudi expert panel recommends using the HPV DNA test followed by colposcopy or cytology (Pap test) followed by colposcopy to screen for CIN2+ in women at risk of cervical cancer. The panel recommends cryotherapy or loop excision electrosurgery procedure (LEEP) over cold knife cone biopsy to treat women at risk of cervical cancer that tests positive for CIN2+. Universal screening for precancerous cervical dysplasia in women in Saudi Arabia is recommended using HPV testing and or cytology. Either cryotherapy or LEEP are preferred for treatment. LIMITATIONS National studies on cervical cancer screening modalities and treatment of precancerous cervical lesions, including HPV prevalence and its association with cervical cancer, are scarce.
Collapse
Affiliation(s)
- Hazem Mahmoud Al-Mandeel
- Hazem Mahmoud Al-Mandeel,, Associate Professor, King Khalid University Hospital,, Obstetrics and Gynecology,, College of Medicine and King Saud Medical University, Medical City,, King Saud University,, PO Box 7805, Riyadh 11472,, Saudi Arabia, T: +966-11-469-1775, F: +966-11-467-9557, , ORCID ID: http://orcid.org/0000-0002-2329-0288
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Xue Y, Toh SY, He P, Lim T, Lim D, Pang CL, Abastado JP, Thierry F. HPV16-E2 induces prophase arrest and activates the cellular DNA damage response in vitro and in precursor lesions of cervical carcinoma. Oncotarget 2016; 6:34979-91. [PMID: 26474276 PMCID: PMC4741503 DOI: 10.18632/oncotarget.5512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 10/01/2015] [Indexed: 11/25/2022] Open
Abstract
Cervical intraepithelial neoplasia (CIN) is caused by human papillomavirus (HPV) infection and is the precursor to cervical carcinoma. The completion of the HPV productive life cycle depends on the expression of viral proteins which further determines the severity of the cervical neoplasia. Initiation of the viral productive replication requires expression of the E2 viral protein that cooperates with the E1 viral DNA helicase. A decrease in the viral DNA replication ability and increase in the severity of cervical neoplasia is accompanied by simultaneous elevated expression of E6 and E7 oncoproteins. Here we reveal a novel and important role for the HPV16-E2 protein in controlling host cell cycle during malignant transformation. We showed that cells expressing HPV16-E2 in vitro are arrested in prophase alongside activation of a sustained DDR signal. We uncovered evidence that HPV16-E2 protein is present in vivo in cells that express both mitotic and DDR signals specifically in CIN3 lesions, immediate precursors of cancer, suggesting that E2 may be one of the drivers of genomic instability and carcinogenesis in vivo.
Collapse
Affiliation(s)
- Yuezhen Xue
- Institute of Medical Biology, A*STAR, Singapore.,Current address: p53 Laboratory, A*STAR, Singapore
| | | | - Pingping He
- Institute of Medical Biology, A*STAR, Singapore
| | - Thimothy Lim
- Department of Gynaecological Oncology, KK Women's and Children's Hospital, Singapore
| | - Diana Lim
- Department of Pathology, National University Hospital, Singapore
| | | | | | | |
Collapse
|
10
|
Asemi Z, Vahedpoor Z, Jamilian M, Bahmani F, Esmaillzadeh A. Effects of long-term folate supplementation on metabolic status and regression of cervical intraepithelial neoplasia: A randomized, double-blind, placebo-controlled trial. Nutrition 2015; 32:681-6. [PMID: 26853484 DOI: 10.1016/j.nut.2015.12.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 12/11/2015] [Accepted: 12/15/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study was conducted to determine the effects of long-term folate supplementation on regression and metabolic status of patients with cervical intraepithelial neoplasia grade 1 (CIN1). METHODS This randomized, double-blind, placebo-controlled trial was performed among 58 women diagnosed with CIN1, ages 18 to 55 y old. Participants were randomly divided into two groups to receive 5 mg/d folate supplements (n = 29) or placebo (n = 29) for 6 mo. Fasting blood samples were taken at baseline and 6 mo after intervention to quantify related markers. RESULTS A greater percentage of women in the folate group had regressed CIN1 (83.3 versus 52.0%, P = 0.019) than those in the placebo group. Long-term folate supplementation resulted in a significant decrease in serum insulin levels (-1.6 ± 6.2 versus +2.6 ± 6.9 μIU/mL, P = 0.018) and homeostatic model assessment-beta cell function (HOMA-B) (-13.0 ± 39.0 versus +11.2 ± 42.3, P = 0.028) compared with the placebo. Additionally, plasma glutathione (GSH) levels were significantly increased (+81.5 ± 264.1 versus -220.9 ± 342.5 μmol/L, P < 0.001) and malondialdehyde (MDA) levels were significantly reduced (-1.0 ± 1.1 versus +0.1 ± 1.6 μmol/L, P = 0.004) in the folate group compared to the placebo. CONCLUSIONS Taken together, folate supplementation (5 mg/d) for 6 mo among women with CIN1 resulted in its regression as well as led to decreased serum insulin, HOMA-B, plasma MDA and increased plasma GSH levels; however, it did not affect other metabolic profiles.
Collapse
Affiliation(s)
- Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Zahra Vahedpoor
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Mehri Jamilian
- Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran; Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
11
|
Methylation in the promoters of HS3ST2 and CCNA1 genes is associated with cervical cancer in Uygur women in Xinjiang. Int J Biol Markers 2014; 29:e354-62. [PMID: 25198553 DOI: 10.5301/jbm.5000107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2014] [Indexed: 01/09/2023]
Abstract
We assessed the suitability of HS3ST2 and CCNA1 genes as biomarkers for the early detection of cervical cancer in Uygur women in Xinjiang, China. Methylation-specific PCR (MSP) and HPV (HPV16 and HPV18)-specific PCR were performed on 110 cervical samples: 40 normal cervices, 10 cervical intraepithelial neoplasia 1 (CIN1), 10 CIN2, 10 CIN3 and 40 cervical cancer tissues. The expression of the 2 genes was measured by reverse transcription PCR (RT-PCR) in 10 methylation-positive and 10 methylation-negative cervical tissues. We found that both HS3ST2 and CCNA1 genes were methylated in 38 of the 40 cervical cancer tissues, 9 of the 10 CIN3, and 6 of the 10 CIN2. In contrast, methylation of these 2 genes was found in only 1 of the 40 normal tissues and none of 10 CIN1. Furthermore, hypermethylated HS3ST2 and CCNA1 genes were correlated with infection with HPV16 and HPV18 in high-grade squamous intraepithelial lesions (HSILs) and cervical cancer (both p<0.05). The expression of HS3ST2 and CCNA1 genes was lower in the methylation-positive cervical tissues than in the methylation-negative cervical tissues. Our results indicate that HS3ST2 and CCNA1 genes may play important roles in HPV-induced cervical cancer and that patients with specific hypermethylated genes may have a greater risk of progressing to invasive cervical cancer.
Collapse
|
12
|
Drug–drug interactions in HIV positive cancer patients. Biomed Pharmacother 2014; 68:665-77. [DOI: 10.1016/j.biopha.2014.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/16/2014] [Indexed: 12/12/2022] Open
|
13
|
Izadi-Mood N, Sarmadi S, Eftekhar Z, Jahanteegh HA, Sanii S. Immunohistochemical expression of p16 and HPV L1 capsid proteins as predictive markers in cervical lesions. Arch Gynecol Obstet 2013; 289:1287-92. [PMID: 24346122 DOI: 10.1007/s00404-013-3124-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 12/04/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE Human papilloma virus (HPV) infection is the most important cause of cervical cancer, but only 2 % of cervical HPV infections will develop into cervical cancer. p16 INK4A has been introduced as a marker for HPV infection in cervix. HPV L1 capsid protein is also known to be associated with the productive phase of HPV infection; however, expression pattern in different HPV-associated cervical lesion and its correlation to p16 expression is not still well understood. The authors aimed to elucidate the relationship between L1 and p16 expression in cervical lesions. METHODS Immunohistochemical studies using antibodies against L1 capsid and P16 proteins were carried out on 89 paraffin-embedded tissue samples including 11 low-grade cervical intraepithelial neoplasias (CIN), 11 high-grade CINs, 20 cervical squamous cell carcinomas (SCC), eight cervical adenocarcinomas and 39 normal cervical tissues as a control group. RESULTS L1 capsid protein was positive in 63.6 % of low-grade CINs and 9.1 % of high-grade CINs; while none of the cervical SCCs, adenocarcinomas or normal cervical tissues showed this marker. In contrast, p16 protein was positive in 81.8 % of low-grade CINs, 90.1 % of high-grade CINs, 90 % of SCCs, 75 % of adenocarcinomas and 10.25 % of normal cervical tissues (p value < 0.001). CONCLUSION Despite the presence of interobserver variation in the histopathologic interpretation of cervical lesions, in more instances definite diagnosis is made by routine histopathological examination and these ancillary tests are supportive in follow-up of the patient.
Collapse
Affiliation(s)
- Narges Izadi-Mood
- Department of Pathology, Women's Hospital, Tehran University of Medical Sciences, Nejatollahi St, Karim Khan Zand Ave, Tehran, Iran,
| | | | | | | | | |
Collapse
|
14
|
Coexisting high-grade vulvar intraepithelial neoplasia (VIN) and condyloma acuminatum: independent lesions due to different HPV types occurring in immunocompromised patients. Am J Surg Pathol 2013; 37:53-60. [PMID: 23026935 DOI: 10.1097/pas.0b013e318263cda6] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The majority of vulvar intraepithelial neoplasia (VIN) is high-grade and is related to high-risk human papillomavirus (HRHPV) (most commonly HPV 16). It is considered to be the precursor of HRHPV-related vulvar squamous cell carcinoma. Vulvar condyloma acuminatum is low-risk HPV (LRHPV)-related (most commonly types 6 and 11) and has virtually no risk of neoplastic progression. While infection with multiple LRHPV and HRHPV types has been reported for cervical squamous intraepithelial lesions, coexisting vulvar condyloma and adjacent high-grade VIN have not been well characterized. Eleven cases of concurrent condyloma acuminatum and adjacent flat high-grade VIN and 3 cases of high-grade VIN with prominent condylomatous architecture were analyzed using immunohistochemical analysis of p16 expression, in situ hybridization (ISH) for HPV detection [HPV 6/11, HPV 16, HPV 18, and HPV wide spectrum (types 6, 11, 16, 18, 31, 33, 35, 45, 51, 52) probes], and HPV typing by a polymerase chain reaction (PCR)-based method (in select cases). All patients had underlying immunosuppressive conditions (human immunodeficiency virus infection or posttransplant therapy). Among the 11 cases of concurrent high-grade VIN and condyloma, the lesions were directly adjacent to one another in 5 cases (with 2 of these demonstrating an intimate admixture of lesions), and in 6 cases the lesions were found in separate tissue sections from the same specimen. Diffuse/strong p16 expression was seen in all high-grade VIN lesions, whereas patchy/weak staining was found in all condylomata. All condylomata contained HPV 6 or 11 as detected by ISH. HRHPV was detected in all of the accompanying high-grade VIN lesions. Ten contained HPV 16 (9 by ISH, 1 by PCR), with the remaining case containing multiple HPV types by PCR. All condylomatous high-grade VIN lesions demonstrated diffuse/strong p16 expression and had evidence of HRHPV (1 with HPV 16 by ISH, 1 with HPV 18 by ISH, and 1 with multiple HPV types by PCR), with no detection of HPV 6 or 11 by ISH. The restriction of LRHPV to condylomatous components and HRHPV to high-grade VIN components of adjacent lesions suggests these are independent lesions caused by different HPV types. Diffuse p16 expression can highlight small foci of high-grade VIN, which may be overlooked in more abundant condylomatous tissue from immunosuppressed patients. The presence of only HRHPV in those VIN lesions with high-grade cytologic features but prominent condylomatous architecture supports their classification as forms of pure high-grade VIN and distinguishes them from condyloma acuminatum.
Collapse
|
15
|
Cheng X, Feng Y, Wang X, Wan X, Xie X, Lu W. The effectiveness of conization treatment for post-menopausal women with high-grade cervical intraepithelial neoplasia. Exp Ther Med 2012; 5:185-188. [PMID: 23251264 PMCID: PMC3524274 DOI: 10.3892/etm.2012.748] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 09/10/2012] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to evaluate the effectiveness of conization in the diagnosis and treatment of high-grade cervical intraepithelial neoplasia (CIN) in post-menopausal women. A total of 101 post-menopausal patients who were diagnosed with high-grade lesion CIN by biopsy and in whom conization was used as the primary treatment were examined and 202 pre-menopausal patients were studied as the controls. Clinical and pathological data including symptoms, cytological examination and HPV DNA test results before and after conization treatment were analyzed. Both the cytological abnormalities (57.9 vs. 58.5%, P=0.260) and the positive rate of the HPV DNA test (89.5 vs. 86.4%, P=0.812) did not show a significant difference between the post- and pre-menopausal group. The rate of satisfactory colposcopy was significantly lower in post-menopausal patients compared with pre-menosausal patients (23.2 vs. 68.9%, P<0.001). Post-menopausal patients presented a significantly lower diagnostic consistency between colpscopy-directed biopsy and conization (46.4 vs. 68.9%, P=0.004), and a significantly higher positive margin rate of conization (20.8 vs. 10.9%, P=0.020). A total of 10 of the 101 post-menopausal and 2 of the 202 pre-menopausal women were diagnosed with invasive cancer by conization and underwent further treatment. In conclusion, these data suggest that conization, as a conservative primary treatment, is not suitable for post-menopausal women with high-grade lesion CIN due to the lower rate of satisfactory colposcopy, lower consistency of diagnosis between colposcopy-directed biopsy and conization, and a higher positive margin of conization.
Collapse
Affiliation(s)
- Xiaodong Cheng
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
| | | | | | | | | | | |
Collapse
|
16
|
Machalek DA, Grulich AE, Jin F, Templeton DJ, Poynten IM. The epidemiology and natural history of anal human papillomavirus infection in men who have sex with men. Sex Health 2012; 9:527-37. [DOI: 10.1071/sh12043] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 07/30/2012] [Indexed: 12/21/2022]
Abstract
Studies on the epidemiology and natural history of anal human papillomavirus (HPV) infection are essential to understand the significance of this virus in the aetiology of anal cancer in men who have sex with men (MSM). This paper presents a review of studies on anal HPV in MSM. For this review, a Medline search was performed to identify English-language articles published in peer-reviewed journals on the epidemiology, natural history and risk factors for anal HPV infection in MSM. Anal HPV prevalence is high in MSM and infection with multiple HPV types is common. The available prospective data suggest detection of new anal HPV infections may also be common. However, with limited epidemiological data available on infection dynamics and associated behavioural risk factors, it is difficult to draw conclusions on how persistent anal HPV infection is in this population.
Collapse
|
17
|
Sarmadi S, Izadi-mood N, Pourlashkari M, Yarandi F, Sanii S. HPV L1 capsid protein expression in squamous intraepithelial lesions of cervix uteri and its relevance to disease outcome. Arch Gynecol Obstet 2011; 285:779-84. [DOI: 10.1007/s00404-011-2010-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Accepted: 07/08/2011] [Indexed: 10/18/2022]
|
18
|
Jung S, Yi L, Kim J, Jeong D, Oh T, Kim CH, Kim CJ, Shin J, An S, Lee MS. The role of vimentin as a methylation biomarker for early diagnosis of cervical cancer. Mol Cells 2011; 31:405-11. [PMID: 21491170 PMCID: PMC3887602 DOI: 10.1007/s10059-011-0229-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 02/28/2011] [Accepted: 03/15/2011] [Indexed: 02/08/2023] Open
Abstract
Multiple cytosine guanine dinucleotides (CpG island) are found in the VIM promoter region. The levels of VIM promoter methylation and VIM gene expression were investigated in 7 cervical cancer cell lines and 50 human tissue samples with a distinctive degree of malignant trans-formation. While multiple CpG sites in the VIM promoter were highly methylated in CIN III and invasive carcinoma cells, they were rarely methylated in normal cells. Our result shows that methylation in the VIM promoter appears to start from CIN I and CIN II, relatively early stages of multistep carcinogenesis. This epigenetic alteration in VIM promoter suggests the availability as a biomarker for the early diagnosis and prevention of cervical cancer. We also show that hypermethylation in the VIM promoter is responsible for transcriptional silencing of the VIM gene in cervical cancer cells. In addition, our result shows that exogenous overexpression of the VIM gene in SiHa cervical cancer cells slightly activated cell proliferation and migration as shown in soft agar colony formation and migration assays.
Collapse
Affiliation(s)
| | | | | | - Dongjun Jeong
- Department of Pathology, College of Medicine, Soonchunhyang University, Cheonan 330-090, Korea
| | | | - Chang-Hwan Kim
- Department of Pathology, College of Medicine, Soonchunhyang University, Cheonan 330-090, Korea
| | - Chang-Jin Kim
- Department of Pathology, College of Medicine, Soonchunhyang University, Cheonan 330-090, Korea
| | - Jin Shin
- Songdo Technopark, Inchon 406-840, Korea
| | | | | |
Collapse
|
19
|
Cotton S, Sharp L, Little J, Cruickshank M, Seth R, Smart L, Duncan I, Harrild K, Neal K, Waugh N. The role of human papillomavirus testing in the management of women with low-grade abnormalities: multicentre randomised controlled trial. BJOG 2010; 117:645-59. [PMID: 20374607 DOI: 10.1111/j.1471-0528.2010.02519.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the value of a single human papillomavirus (HPV) test in making decisions on management of women with cervical cytology showing borderline nuclear abnormality (BNA) or mild dyskaryosis. In particular, to determine whether information on high-risk (hr) HPV status would be valuable in the choice between (1) cytological surveillance versus immediate referral to colposcopy, and (2) at colposcopy, between biopsy and recall versus immediate large loop excision of the transformation zone (LLETZ). DESIGN Multicentre individually randomised controlled trial, nested within the NHS Cervical Screening Programmes, investigating the value of HPV testing by testing for interactions between HPV status and (1) cytological surveillance versus colposcopy, and (2) biopsy and recall versus immediate LLETZ. Setting Grampian, Tayside and Nottingham. Population Women (n = 4439), aged 20-59 years, with a cytology test showing borderline nuclear abnormalities or mild dyskaryosis during October 1999 to October 2002. METHODS High-risk HPV status was determined at recruitment using the polymerase chain reaction assay with the GP5+/6+ general primer system. The results of this HPV testing were not disclosed to either the participating women or to those involved in their management. Women were randomised to either (1) 6-monthly cytological screening in primary care or (2) referral for colposcopy. Human papillomavirus status was used to stratify both randomisations. All women were followed for 3 years, concluding with an invitation to an exit appointment at which colposcopic examination was undertaken. In addition, in women who were randomised to initial colposcopy and underwent colposcopy, the association between hrHPV status and presence of cervical intraepithelial neoplasia (CIN) grade 2 or more severe disease (henceforth CIN2 or worse) was examined. MAIN OUTCOME MEASURES Sensitivity, specificity, positive and negative predictive values of the HPV test for predicting CIN2 or worse and the implications for the choice of management between cytological surveillance and immediate referral for colposcopy. RESULTS There were no significant interactions between management and HPV status. Hence, in women with mild dyskaryosis or BNA who are HPV positive, there is no advantage of (1) immediate colposcopy over cytological surveillance (P = 0.76) or (2) immediate LLETZ over biopsy and recall (P = 0.27). The sensitivity of HPV testing for detection of CIN2 or worse was 75.2% (95% CI 68.8-81.0%) among women with mild dyskaryosis and 69.9% (95% CI 61.7-77.3%) among those with BNA. Specificity was higher in those with BNA (71.3%; 95% CI 68.5-74.1%) than in those with mild dyskaryosis (46.9%; 95% CI 42.2-51.6%). Sensitivity decreased with increasing age whereas specificity increased. The negative predictive value was high, particularly among women with BNA (94.5%; 95% CI 92.9-96.0%). Across all ages, 22% of women who had CIN2 or worse were HPV negative. Conversely, 40% of those who were HPV positive did not have CIN. HPV was a much more reliable predictor in women aged over 40 years. CONCLUSIONS We conclude that in younger women with low-grade cytological abnormalities, a single HPV test would not be useful in determining who should be referred for colposcopy or the most effective management at colposcopy. In women over 40, a negative HPV test could be used to rule out further investigation.
Collapse
Affiliation(s)
- S Cotton
- Department of Public Health, University of Aberdeen, Aberdeen, UK
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Down-regulation of phospho-non-receptor Src tyrosine kinases contributes to growth inhibition of cervical cancer cells. Med Oncol 2010; 28:1495-506. [DOI: 10.1007/s12032-010-9583-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 05/19/2010] [Indexed: 11/26/2022]
|
21
|
p16ink4a and HPV L1 Immunohistochemistry is Helpful for Estimating the Behavior of Low-grade Dysplastic Lesions of the Cervix Uteri. Am J Surg Pathol 2008; 32:1715-20. [DOI: 10.1097/pas.0b013e3181709fbf] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
Blatter MM, Monk BJ. The pediatrician's role in preventing cervical cancer. Clin Pediatr (Phila) 2008; 47:627-38. [PMID: 18698095 DOI: 10.1177/0009922808315219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mark M Blatter
- Primary Physicians Research, 1580 McLaughlin Run Rd, Pittsburgh, PA 15241, USA.
| | | |
Collapse
|
23
|
Why do human papillomavirus infections induce sharply demarcated lesions of the cervix? J Low Genit Tract Dis 2008; 12:8-10. [PMID: 18162805 DOI: 10.1097/lgt.0b013e31806dba20] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chronic infections with high-risk human papilloma virus (HPV) have been established to cause cervical cancer. The causal pathogenesis of cervical carcinoma is believed to be the result of the proliferation of one or, at most, a few HPV-transformed cells. So far, it has not been possible to identify and analyze these early initial lesions or cell clusters. Invasive cervical cancer arises in cervical intraepithelial neoplasia, which in turn develops preferentially in squamous metaplasia in clearly demarcated fields. These fields are the main salient morphologic characteristic in cervical intraepithelial neoplasia and can be recognized colposcopically as well as histomorphologically. The precise mechanism for the development of separate, well-delineated fields in HPV-related intraepithelial neoplasia and the variable susceptibility of stem or reserve cells for different HPV genotypes remains unsolved. In cervical carcinogenesis, the link between formal pathogenesis apparent as colposcopic and histomorphologic changes and the causal pathogenesis of HPV-induced genetic changes is still missing and an issue for future research.
Collapse
|
24
|
Comparison of AMPLICOR® and Hybrid Capture II® assays for high risk HPV detection in normal and abnormal liquid-based cytology: Use of INNO-LiPA Genotyping assay to screen the discordant results. J Clin Virol 2008; 41:104-10. [DOI: 10.1016/j.jcv.2007.09.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 07/18/2007] [Accepted: 09/20/2007] [Indexed: 01/08/2023]
|
25
|
Al-Nafussi A. Histopathological challenges in assessing invasion in squamous, glandular neoplasia of the cervix. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.cdip.2006.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|