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Tung HJ, Wang YC, Lin CY, Liao MJ, Pan YB, Jung SM, Wang CC, Huang HJ, Chao A, Chou HH, Chang TC, Yang LY, Lai CH. Human papillomavirus prevalence, genotype distribution, and prognostic factors of vaginal cancer. Int J Cancer 2024; 155:1996-2008. [PMID: 39046705 DOI: 10.1002/ijc.35105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/22/2024] [Accepted: 05/22/2024] [Indexed: 07/25/2024]
Abstract
We aimed to investigate human papillomavirus (HPV) prevalence and genotype distribution and prognostic factors in vaginal cancer (VC). VC patients who received treatment between 1989 and 2020 were retrospectively reviewed. L1 general polymerase chain reaction (PCR) followed by HPV Blot (King Car, I-Lan, Taiwan) and E6 type-specific-PCR were performed for genotyping firstly. P16 and p53 immunohistochemistry staining was performed. Univariate and multivariate analyses identified predictors of clinical outcomes.79 VC patients were eligible for analysis. 73 patients (92.4%) were squamous cell carcinoma (SCC) and 6 (7.6%) as non-SCC. The median follow-up time was 134.3 months (range 0.9-273.4). Among nine initially HPV-negative cases, seven were identified as being positive through HPV16/18/45/52/58 whole-genome amplification followed by Sanger sequencing (WGASS). HPV DNA sequences were detected in 98.6% of SCC and 83.3% of non-SCC, respectively, with HPV16 (49.4%), HPV52 (15.2%) and HPV58 (8.9%) being predominant. Patients with paraaortic lymph node (LN) metastasis had a 5-year cancer-specific survival (CSS) rate of 0%. Multivariate analysis revealed that only p16 and stage were significantly correlated with prognosis. Variables with strong correlations (p16- and HPV-positivity, LN metastasis and stage), were included in models 2-5 alternatively. Stage III/IV (hazard ratio [HR] = 3.64-4.56) and LN metastasis (HR = 2.81-3.44) were significant negative predictors of CSS, whereas p16-positivity (HR = 0.29-0.32) and HPV-positivity (HR = 0.14) were related to better prognosis. In conclusion, 97.5% of VCs were HPV-positive with WGASS. Stage III/IV and LN metastasis were significant negative predictors, whereas p16- and HPV-positivity were significantly associated with better prognosis.
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Affiliation(s)
- Hsiu-Jung Tung
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - You-Chen Wang
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Branch and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Chiao-Yun Lin
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Min-Jie Liao
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Branch and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Yu-Bin Pan
- Clinical Trial Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Ming Jung
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Pathology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chun-Chieh Wang
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Huei-Jean Huang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Angel Chao
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hung-Hsueh Chou
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Chang Chang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Lan-Yan Yang
- Division of Clinical Trial, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chyong-Huey Lai
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
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Huang B, Zhang D, Wang H, Li S, Guo J, Cui S, Chen X, Hong Y, Wu Z. Systemic administration of a potent mouse monoclonal antibody provides multisite protection against HPV16 infection. Int Immunopharmacol 2024; 143:113272. [PMID: 39353396 DOI: 10.1016/j.intimp.2024.113272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 09/21/2024] [Accepted: 09/25/2024] [Indexed: 10/04/2024]
Abstract
Although preventive vaccines for Human Papillomaviruses (HPV) are available, a definitive cure for the viral infection itself is currently lacking. There is a sizable population that remains inaccessible to HPV vaccination due to reasons such as high costs or lack of availability of the vaccines. Therefore, there remains a significant population susceptible to HPV infection. Persistent multisite infections with high-risk HPV types can cause cancer at several different anatomic sites.Especially HPV16 is a key etiologic factor for cervical, other ano-genital and oropharyngeal cancers. Therefore, it is imperative to develop pharmaceutical interventions for the treatment of viral infections. In this study, a panel of 9 neutralizing antibodies was screened using the hybridoma technique, with 20F6 being identified as the representative antibody. The purified 20F6 exhibited an IC50 of 0.0011 μg/ml against HPV16, demonstrating potent viral inhibitory activity. Moreover, it displayed cross-neutralizing efficacy towards other Alphapapillom 9 subtypes including HPV31, HPV33, HPV52, and HPV58 with respective IC50 values of 2.0 μg/ml, 7.3 μg/ml, 1.7 μg/ml, and 3.0 μg/ml. 20F6 recognizes the linear epitope MSLW, the first four amino-acids located at the very N-terminus of the HPV16 L1 protein. Administration of 20F6, 24 h prior to and following HPV16 pseudo-virion (PSV) challenge, conferred protection against infection in mice at doses as low as 1 mg/kg. Following intraperitoneal administration of 20F6, neutralizing antibodies were consistently detected at both oral and vaginal sites, indicating that prophylactic systemic administration of 20F6 may confer efficient protection against multiple susceptible mucosal sites.
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Affiliation(s)
- Bilian Huang
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Doudou Zhang
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Hongyun Wang
- Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Siyu Li
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Jianjun Guo
- Yancheng Clinical College, Xuzhou Medical University, Yancheng, China
| | - Shengwei Cui
- School of Life Sciences, Ningxia University, Yinchuan, China
| | - Xiaoping Chen
- Yancheng Clinical College, Xuzhou Medical University, Yancheng, China.
| | - Ying Hong
- Nanjing International Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhiwei Wu
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China; State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, China; Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.
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Vahteristo M, Leinonen MK, Sarkeala T, Anttila A, Heinävaara S. Lower incidence of vaginal cancer after cervical human papillomavirus screening - long-term follow-up of Finnish randomized screening trial. Prev Med 2024; 185:108031. [PMID: 38849059 DOI: 10.1016/j.ypmed.2024.108031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/21/2024] [Accepted: 06/04/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE Around 70% of vaginal cancers and 40-50% of vulvar cancers are attributable to human papillomavirus (HPV). Globally the burden of these diseases is estimated to grow due to the increasing HPV prevalence and rapidly aging global population. We aimed to examine if HPV screening for cervical cancer has an additional beneficial effect in preventing vaginal and vulvar cancers. To assess this, we used long-term follow-up data from the Finnish randomized HPV screening trial. METHODS Between 2003 and 2008, over 236,000 women were individually randomized (1:1) to primary HPV or cytology screening in Southern Finland. We followed this cohort up to the year 2020. To compare the study arms, we calculated site-specific and pooled incidence rate ratios (IRRs) and mortality rate ratios (MRRs) for vaginal and vulvar cancers using Poisson regression. RESULTS During 3,5 million person-years of follow-up, the IRR for vaginal cancer in the HPV arm compared to the cytology arm was 0.40 (95% CI 0.17-0.88) and the corresponding MRR was 0.74 (95% 0.21-2.24). The corresponding IRR for vulvar cancer was 0.73 (95% 0.50-1.08) and the MRR was 0.64 (95% 0.23-1.62). The pooled IRR was 0.67 (95% 0.47 ̶ 0.95) and MRR 0.67 (95% 0.31 ̶ 1.37). CONCLUSION We found lower incidence of vaginal cancers with HPV screening compared to cytology screening. To validate our results, we recommend analyzing data on vaginal and vulvar cancers also from other HPV screening studies.
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Affiliation(s)
- Maija Vahteristo
- Finnish Cancer Registry, 00130 Helsinki, Finland; Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland.
| | - Maarit K Leinonen
- Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Ahti Anttila
- Finnish Cancer Registry, 00130 Helsinki, Finland
| | - Sirpa Heinävaara
- Finnish Cancer Registry, 00130 Helsinki, Finland; Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
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Javadi K, Ferdosi-Shahandashti E, Rajabnia M, Khaledi M. Vaginal microbiota and gynecological cancers: a complex and evolving relationship. Infect Agent Cancer 2024; 19:27. [PMID: 38877504 PMCID: PMC11179293 DOI: 10.1186/s13027-024-00590-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/04/2024] [Indexed: 06/16/2024] Open
Abstract
The vagina hosts a community of microorganisms known as the vaginal microbiota. This community is relatively stable and straightforward, with Lactobacillus species being the most dominant members. The vaginal microbiota has various functions that are essential for maintaining human health and balance. For example, it can metabolise dietary nutrients, produce growth factors, communicate with other bacteria, modulate the immune system, and prevent the invasion of harmful pathogens. When the vaginal microbiota is disrupted, it can lead to diseases and infections. The observed disturbance is distinguished by a reduction in the prevalence of Lactobacillus and a concurrent rise in the number of other bacterial species that exhibit a higher tolerance to low oxygen levels. Gynecologic cancers are a group of cancers that affect the female reproductive organs and tissues, such as the ovaries, uterus, cervix, vagina, vulva, and endometrium. These cancers are a major global health problem for women. Understanding the complex interactions between the host and the vaginal microorganisms may provide new insights into the prevention and treatment of gynecologic cancers. This could improve the quality of life and health outcomes for women.
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Affiliation(s)
- Kasra Javadi
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Elaheh Ferdosi-Shahandashti
- Biomedical and Microbial Advanced Technologies Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehdi Rajabnia
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Mansoor Khaledi
- Department of Microbiology and Immunology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
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Zhao M, Zhou D, Zhang M, Kang P, Cui M, Zhu L, Luo L. Characteristic of persistent human papillomavirus infection in women worldwide: a meta-analysis. PeerJ 2023; 11:e16247. [PMID: 38025679 PMCID: PMC10655709 DOI: 10.7717/peerj.16247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives We aimed to estimate the genotype distribution of persistent human papillomavirus (HPV) infection in females worldwide, and provided a scientific basis for the prevention strategies of cervical cancer (CC) and the development of HPV vaccines. Methods Both English and Chinese databases were researched from the inception to July 2023. The pooled persistent HPV infection prevalence was calculated using a random effects model. The subgroup analysis was performed to explore the heterogeneity. Publication bias was evaluated using funnel plot, Egger's and Begg's test. Results Twenty-eight studies with 27,335 participants were included. The pooled prevalence of persistent HPV infection was 29.37% (95% CI [24.05%∼35.31%]), and the genotypes with the persistent infection prevalence were HPV16 (35.01%), HPV52 (28.19%), HPV58 (27.06%), HPV18 (25.99%), HPV33 (24.37%), HPV31 (23.35%), HPV59 (21.87%), HPV39 (19.54%), HPV68 (16.61%) and HPV45 (15.05%). The prevalence of multiple and single HPV persistent infection were 48.66% and 36.71%, respectively; the prevalence of persistent HPV infection in different age groups (<30, 30∼39, 40∼49, >50) were 29.83%, 28.39%, 22.24% and 30.22%, respectively. The follow-up time was significantly associated with heterogeneity by subgroup analysis (P < 0.05), and the prevalence of persistent infection decreased with longer follow-up time. Conclusions Multiple infections were more likely to occur persistent HPV infection than single infection. In addition to HPV vaccination, we should emphasize the follow-up management for women under 30 and over 50 years old, those with high-risk HPV infection (HPV59, 39, 68) and multiple infections.
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Affiliation(s)
- Ming Zhao
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Dan Zhou
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Min Zhang
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Peipei Kang
- Shandong Mental Health Center, Shandong University, Jinan, Shandong, China
| | - Meimei Cui
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
- School of Basic Medical, Weifang Medical College, Weifang, Shandong, China
| | - Liling Zhu
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Limei Luo
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
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Vali M, Maleki Z, Jahani MA, hajizade-valokolaee M, Hashemi SN, sedighi S, Ghelichi-ghojogh M, Hassanipour S, Solati A, Javanian M, Nikbakht HA. Survival rate of vaginal cancer in Asian countries: a systematic review and meta-analysis. Ann Med Surg (Lond) 2023; 85:5577-5583. [PMID: 37920653 PMCID: PMC10619580 DOI: 10.1097/ms9.0000000000001097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/13/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction Vaginal cancer is one of the major causes of mortality in women, which mostly takes place in low- and middle-income countries. Assessing the survival rate of vaginal cancer is essential to investigate the success rate of current treatments and screening tools. This study aims to determine the survival rate of vaginal cancer in Asia. Methods This systematic review was carried out using four international databases, including Medline/Pubmed, ProQuest, Scopus, Web of Knowledge, and also Google Scholar. Articles were investigated up to the end of August 2021. The authors utilized the Newcastle-Ottawa Scale to evaluate the quality of the articles. Evaluating the papers for heterogeneity was performed using the Cochrane test and I² statistic. Meta-regression analysis was also applied based on the year of the study. Results Three articles (13 records) fulfilled the inclusion criteria. Based on the random model, the overall 5-year survival rate was 74.63%. Also, the rates of survival in relation to the type of treatment including chemotherapy, radiotherapy, or other modalities, were 78.53, 78.44, and 68.54%, respectively. According to meta-regression analysis, no correlation was found between the survival rate and the year of the study. Conclusion The vaginal cancer survival rate is lower in Asian countries compared to that of developed countries. Increasing patient survival rates in such countries is crucial by implementing newer diagnostic tools, advanced surgical techniques, and goal-oriented treatments. Early diagnosis in lower stages and educating the populations about risk factors and preventative measures are also necessary for raising the rate of survival.
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Affiliation(s)
- Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Maleki
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad-Ali Jahani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam hajizade-valokolaee
- Health assistant, midwifery comprehensive health center, Babol University of Medical Sciences, Babol, Iran
| | | | - Saman sedighi
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Mousa Ghelichi-ghojogh
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Arezo Solati
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Chelmow D, Cejtin H, Conageski C, Farid H, Gecsi K, Kesterson J, Khan MJ, Long M, O'Hara JS, Burke W. Executive Summary of the Lower Anogenital Tract Cancer Evidence Review Conference. Obstet Gynecol 2023; 142:708-724. [PMID: 37543740 PMCID: PMC10424818 DOI: 10.1097/aog.0000000000005283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 08/07/2023]
Abstract
The Centers for Disease Control and Prevention sponsored a project conducted by the American College of Obstetricians and Gynecologists to develop educational materials for clinicians on the prevention and early diagnosis of gynecologic cancers. For this final module, focusing on the cancers of the lower anogenital tract (vulva, vagina, and anus), a panel of experts in evidence assessment from the Society for Academic Specialists in General Obstetrics and Gynecology, ASCCP, and the Society of Gynecologic Oncology reviewed relevant literature and current guidelines. Panel members conducted structured literature reviews, which were then reviewed by other panel members. Representatives from stakeholder professional and patient advocacy organizations met virtually in September 2022 to review and provide comment. This article is the executive summary of the review. It covers prevention, early diagnosis, and special considerations of lower anogenital tract cancer. Knowledge gaps are summarized to provide guidance for future research.
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Affiliation(s)
- David Chelmow
- Departments of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, Feinberg School of Medicine Northwestern University, Stroger Hospital, Chicago, Illinois, University of Colorado School of Medicine, Aurora, Colorado, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, Medical College of Wisconsin, Milwaukee, Wisconsin, Stanford University School of Medicine, Palo Alto, California, Mayo Clinic Alix School of Medicine, Rochester, Minnesota, and Stony Brook University Hospital, Stony Brook, New York; the Division of Gynecologic Oncology, UPMC-Central PA, Mechanicsburg, Pennsylvania; and the American College of Obstetricians and Gynecologists, Washington, DC
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Dong H, Li H, Wang L, Yuan Y, Zhang D, Zhou L, Wang T, Yang C. Clinical analysis of 175 cases of vaginal intraepithelial neoplasia. Eur J Obstet Gynecol Reprod Biol 2023; 287:232-236. [PMID: 37392699 DOI: 10.1016/j.ejogrb.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE To evaluate the risk factors related to vaginal intraepithelial neoplasia (VaIN) severity. STUDY DESIGN This retrospective study included patients with histologically confirmed VaIN diagnosed at Hubei Provincial Maternal and Child Health Hospital, China, between January 2017 and October 2021. The primary outcomes were persistence, remission, progression, and recurrence. Multiple ordinal logistic regression analysis was used to analyze the risk factors of VaIN severity. RESULTS A total of 175 patients were included, 135 (77.1%) with VaIN 1, 19 (10.9%) with VaIN 2, and 21 (12%) with VaIN 3. Patients with VaIN 3 were older than those with VaIN1 2 (P < 0.001). The ratio of patients with concomitant cervical lesions increased with VaIN grade (23.7%, 47.4%, and 47.6% for VaIN 1, 2, and 3, respectively). The proportion of patients with intraepithelial neoplasia (CIN) 3 increased with the VaIN grade (3.1%, 44.5%, and 80% for VaIN 1, 2, and 3, respectively, respectively; all P < 0.001). In patients with VaIN 1, 19.4% had regression (spontaneous regression in 90.5%) and 80.6% underwent laser ablation (regression in 93.1%). In patients with VaIN 2 and 3, 3.1% showed no regression, 53.1% underwent laser ablation (regression in 76.4%), and 73.8% underwent excision (regression in 78.7%). Age (OR = 1.05, 95 %CI: 1.01-1.10, P = 0.010) and concomitant cervical lesion (OR = 6.99, 95 %CI: 2.31-21.12, P = 0.001) were independent risk factors for the severity of VaIN. CONCLUSION Age and cervical lesions might be the risk factors for VaIN severity.
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Affiliation(s)
- Hong Dong
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Hongying Li
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China.
| | - Liming Wang
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Yuqin Yuan
- Department of Gynecology, School of Medicine, Wuhan University of Science and Technology, Wuhan 430062, China
| | - Dunlan Zhang
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Limin Zhou
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Tinghui Wang
- Department of Gynecology, School of Medicine, Wuhan University of Science and Technology, Wuhan 430062, China
| | - Chunyan Yang
- Health College, Medical Department, Hubei University of Science and Technology, Xianning 437100, China
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Jones-Pauley M, Kodali S, Basra T, Victor DW. Women's health issues in solid organ transplantation: Breast and gynecologic cancers in the post-transplant population. World J Transplant 2023; 13:129-137. [PMID: 37388393 PMCID: PMC10303419 DOI: 10.5500/wjt.v13.i4.129] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/19/2023] [Accepted: 05/31/2023] [Indexed: 06/16/2023] Open
Abstract
The success of solid organ transplant has steadily improved which has led to a unique set of post-transplant issues. The rates of de novo cancer in the solid organ transplant recipient population are higher than those in the general population. There is growing evidence that breast and gynecologic cancers may have a higher mortality rate in post-transplant patients. Cervical and vulvovaginal cancers specifically have a significantly higher mortality in this population. Despite this increased mortality risk, there is currently no consistent standard in screening and identifying these cancers in post-transplant patients. Breast, ovarian and endometrial cancers do not appear to have significantly increased incidence. However, the data on these cancers remains limited. Further studies are needed to determine if more aggressive screening strategies would be of benefit for these cancers. Here we review the cancer incidence, mortality risk and current screening methods associated with breast and gynecologic cancers in the post-solid organ transplant population.
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Affiliation(s)
- Michelle Jones-Pauley
- Department of Gastroenterology, Houston Methodist Hospital, Houston, TX 77008, United States
| | - Sudha Kodali
- Department of Transplant Hepatology, Houston Methodist Hospital, Houston, TX 77030, United States
| | - Tamneet Basra
- Department of Transplant Hepatology, Houston Methodist Hospital, Houston, TX 77030, United States
| | - David W Victor
- Department of Transplant Hepatology, Houston Methodist Hospital, Houston, TX 77030, United States
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Plotzker RE, Vaidya A, Pokharel U, Stier EA. Sexually Transmitted Human Papillomavirus: Update in Epidemiology, Prevention, and Management. Infect Dis Clin North Am 2023; 37:289-310. [PMID: 37105644 DOI: 10.1016/j.idc.2023.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
This review presents the epidemiology, pathophysiology, prevention, and management of sexually transmitted human papillomavirus (HPV) and its associated diseases. HPV is the most common sexually transmitted infection worldwide. Prevalence varies regionally. Low-risk strains cause anogenital warts, which can be managed with patient- or provider-applied therapies. High-risk strains cause lower anogenital cancers. Primary and secondary prevention strategies include vaccination and screening for precancerous lesions, respectively. Management of abnormal screening results vary by test result, anatomic site, and individual cancer risk. Approaches include close rescreening, high-resolution visualization with biopsy, and-when biopsy-proven precancer is identified-removal or destruction of the lesion.
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Affiliation(s)
- Rosalyn E Plotzker
- California Prevention Training Center, University of California San Francisco, Bixby Center for Global Reproductive Health 490 Illinois Street, 10th Floor, San Francisco, CA 94143, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, Mission Hall: Global Health and Clinical Sciences, Box 0560 550 16th Street, San Francisco, CA 94143, USA.
| | - Akanksha Vaidya
- California Prevention Training Center, University of California San Francisco, Bixby Center for Global Reproductive Health 490 Illinois Street, 10th Floor, San Francisco, CA 94143, USA
| | - Utsav Pokharel
- California Emerging Infections Program, HPV Impact, 360 22nd Street #750, Oakland, CA 94612, USA
| | - Elizabeth A Stier
- Boston University School of Medicine, Boston Medical Center, 771 Albany Street, Dowling 4, Boston, MA 02118, USA
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11
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Disis ML, Adams SF, Bajpai J, Butler MO, Curiel T, Dodt SA, Doherty L, Emens LA, Friedman CF, Gatti-Mays M, Geller MA, Jazaeri A, John VS, Kurnit KC, Liao JB, Mahdi H, Mills A, Zsiros E, Odunsi K. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of gynecologic cancer. J Immunother Cancer 2023; 11:e006624. [PMID: 37295818 PMCID: PMC10277149 DOI: 10.1136/jitc-2022-006624] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 06/12/2023] Open
Abstract
Advanced gynecologic cancers have historically lacked effective treatment options. Recently, immune checkpoint inhibitors (ICIs) have been approved by the US Food and Drug Administration for the treatment of cervical cancer and endometrial cancer, offering durable responses for some patients. In addition, many immunotherapy strategies are under investigation for the treatment of earlier stages of disease or in other gynecologic cancers, such as ovarian cancer and rare gynecologic tumors. While the integration of ICIs into the standard of care has improved outcomes for patients, their use requires a nuanced understanding of biomarker testing, treatment selection, patient selection, response evaluation and surveillance, and patient quality of life considerations, among other topics. To address this need for guidance, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline. The Expert Panel drew on the published literature as well as their own clinical experience to develop evidence- and consensus-based recommendations to provide guidance to cancer care professionals treating patients with gynecologic cancer.
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Affiliation(s)
- Mary L Disis
- Cancer Vaccine Institute, University of Washington, Seattle, Washington, USA
| | - Sarah F Adams
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA
| | - Jyoti Bajpai
- Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Marcus O Butler
- Department of Medical Oncology and Hematology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada
| | - Tyler Curiel
- Dartmouth-Hitchcock's Norris Cotton Cancer Center, Dartmouth Medical School, Hanover, New Hampshire, USA
| | | | - Laura Doherty
- Program in Women's Oncology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Leisha A Emens
- Department of Medicine, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - Claire F Friedman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Margaret Gatti-Mays
- Pelotonia Institute for Immuno-Oncology, Division of Medical Oncology, The Ohio State University, Columbus, Ohio, USA
| | - Melissa A Geller
- Department of Obstetrics, Gynecology & Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Amir Jazaeri
- Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Veena S John
- Department of Medical Oncology & Hematology, Northwell Health Cancer Institute, Lake Success, New York, USA
| | - Katherine C Kurnit
- University of Chicago Medicine Comprehensive Cancer Center, University of Chicago, Chicago, Illinois, USA
| | - John B Liao
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Haider Mahdi
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Anne Mills
- Department of Pathology, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Emese Zsiros
- Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Kunle Odunsi
- The University of Chicago Medicine Comprehensive Cancer Center, Chicago, Illinois, USA
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12
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Nellessen T, Ebner B, Pyrgidis N, Ledderose S, Kretschmer A, Marcon J, Teupser D, Mayr D, Faihs V, Stief CG, French LE, Herlemann A, Reinholz M. Characterization of Human Papilloma Virus in Prostate Cancer Patients Undergoing Radical Prostatectomy-A Prospective Study of 140 Patients. Viruses 2023; 15:1264. [PMID: 37376564 DOI: 10.3390/v15061264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/21/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The association between human papilloma virus (HPV) and the pathogenesis of prostate cancer (PCa) is still controversial. Existing studies often lack information about clinical risk factors, are limited by their retrospective design or only use a single detection method for HPV. MATERIAL AND METHODS A total of 140 patients undergoing radical prostatectomy (RP) for PCa at the Department of Urology, Ludwig Maximilian University of Munich, Germany, were prospectively enrolled. Knowledge of HPV and sociodemographic parameters were assessed with questionnaires. The following methods were used for HPV detection: RP specimens were tested for HPV DNA by PCR. If HPV DNA was detected, an LCD-Array hybridization technique was used for HPV subtyping, and immunohistochemical staining for p16 was performed as a surrogate marker for HPV infection. Serological titers of HPV-16 L1 antibodies were measured using an HPV-16-specific immunoassay. RESULTS HPV DNA was detected in 9.3% (13/140) of RP specimens, with HPV-16 being the most predominantly detected subtype (5/13 = 39%). HPV-16 L1 antibody levels were below the limit of detection in 98% of patients (137/140). We found no significant difference between HPV PCR-positive (HPV+) and -negative (HPV-) patients in terms of HPV-16 antibody levels, history of HPV-associated diseases, level of education or marital status. Seventy-five percent of all PCa patients had never heard of HPV before. An acinar adenocarcinoma of the prostate was the most frequently detected histologic type in both HPV+ (100%) and HPV- (98%) patients (p = 0.86). HPV+ patients had fewer positive biopsy cores (3.5 vs. 5.8; p = 0.01) and a lower maximal tumor infiltration rate per core (37% vs. 57%; p = 0.03) compared to HPV- patients. However, when analyzing the whole prostate and the lymph nodes after RP, there were no significant differences in TNM stage, Gleason score or tumor volume between both groups. In a subgroup analysis of all high-risk HPV patients (n = 6), we found no significant differences in sociodemographic, clinical or histopathological parameters compared to HPV- or low-risk HPV+ patients. CONCLUSION In our prospective study, we were not able to prove a clinically significant impact of HPV status on tumor characteristics in RP specimens. Most men with PCa had never heard of HPV, despite its proven causal association with other tumor entities.
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Affiliation(s)
- Tobias Nellessen
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
- Department of Dermatology and Allergy, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Benedikt Ebner
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Nikolaos Pyrgidis
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Stephan Ledderose
- Institute of Pathology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Alexander Kretschmer
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Julian Marcon
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Daniel Teupser
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Doris Mayr
- Institute of Pathology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Valentina Faihs
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, 80802 Munich, Germany
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Annika Herlemann
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
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13
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Trétarre B, Dantony E, Coureau G, Defossez G, Guizard AV, Delafosse P, Daubisse L, Velten M, Karima Hammas, Barra S, Lapotre B, Plouvier S, d'Almeida T, Molinié F, Woronoff AS. Trends in incidence of invasive vaginal cancer in France from 1990 to 2018 and survival of recently diagnosed women - A population-based study. Eur J Obstet Gynecol Reprod Biol 2023; 283:125-129. [PMID: 36842246 DOI: 10.1016/j.ejogrb.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/26/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE The aim of this study was to analyze trends in the incidence of vaginal cancer in France over a 28-year period and to present survival for recently-diagnosed women. METHODS French cancer registries provided data on invasive vaginal cancers diagnosed from 1990 to 2015 and followed up through June 2018. Trends in incidence were analyzed using a Poisson model with a bidimensional penalized spline of age and year at diagnosis. Net survival analysis was restricted to recently-diagnosed cases (2010-2015) and used a novel approach based on a bidimensional penalized spline of age and time-since-diagnosis to model excess mortality hazard. RESULTS With 162 new cases estimated in France in 2018, vaginal cancer represented 0.9 % of genital cancers in French women. In 2018, the world population age-standardized incidence rate was 0.2 per 100,000 person-years, median age at diagnosis was 75 years. The standardized incidence rate decreased significantly by 3 % per year (95 % CI, -3.8; -2.2) between 1990 and 2018 (0.4 cases per 100,000 person-year in 1990, vs 0.2 in 2018). Age-standardized net survival at 1 and 5 years after diagnosis was respectively 74 % and 45 %. CONCLUSIONS This study confirms that vaginal cancer is still a rare malignancy in France with 5-year net survival that remains low. We observed a consistent decrease in the incidence rate between 1990 and 2018. It may be too early to attribute these trends to a positive impact of vaccination campaigns against hrHPV infection, since vaginal cancer mainly affects older women and HPV vaccination has only been available since the early 2000s, and only targets young girls.
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Affiliation(s)
- Brigitte Trétarre
- Registre des Tumeurs de l'Hérault, 208 rue des Apothicaires, Montpellier, France; CERPOP INSERM U1295, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse F-31073, France.
| | - Emmanuelle Dantony
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biométrie et Biologie Evolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Gaëlle Coureau
- FRANCIM Network, Toulouse F-31073, France; Epicene, Centre Inserm U1219/CHU de Bordeaux, Service d'information Médicale, Université Bordeaux, Bordeaux, France
| | - Gautier Defossez
- FRANCIM Network, Toulouse F-31073, France; Registre général des cancers de Poitou-Charentes, Pôle Biologie, Pharmacie et Santé Publique, CHU de Poitiers, Poitiers, France; Université de Poitiers, Poitiers, France; INSERM Centre d'Investigation Clinique CIC1402, Poitiers, France
| | - Anne-Valérie Guizard
- FRANCIM Network, Toulouse F-31073, France; Registre Général des Tumeurs du Calvados, Caen, France
| | - Patricia Delafosse
- FRANCIM Network, Toulouse F-31073, France; Registre Général des Cancers de l'Isère, Meylan, France
| | - Laetitia Daubisse
- CERPOP INSERM U1295, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse F-31073, France; Claudius Regaud Institute, Regional Cancer Center, IUCT-O, Tarn Cancer Registry, Toulouse, F-31059, France
| | - Michel Velten
- FRANCIM Network, Toulouse F-31073, France; Registre des Cancers du Haut-Rhin, Mulhouse, France
| | - Karima Hammas
- FRANCIM Network, Toulouse F-31073, France; Registre des Cancers du Haut-Rhin, ARER68, Groupe Hospitalier de la Région de Mulhouse et Sud-Alsace (GHRMSA), Mulhouse, France
| | - Simona Barra
- FRANCIM Network, Toulouse F-31073, France; Registre des Cancers de la Manche, Cherbourg-Octeville, France
| | - Bénédicte Lapotre
- FRANCIM Network, Toulouse F-31073, France; Registre du cancer de la Somme, hôpital nord CHU Amiens-Picardie, Amiens, France
| | - Sandrine Plouvier
- FRANCIM Network, Toulouse F-31073, France; Registre général des cancers de Lille et de sa région, Lille, France
| | - Tania d'Almeida
- FRANCIM Network, Toulouse F-31073, France; Registre général des cancers de la Haute-Vienne - CHU de Limoges, Limoges, France
| | - Florence Molinié
- CERPOP INSERM U1295, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse F-31073, France; Registre des Cancers de Loire-Atlantique et Vendee, CHU de Nantes, France
| | - Anne-Sophie Woronoff
- FRANCIM Network, Toulouse F-31073, France; Doubs Cancer Registry, Besançon University Hospital, Besançon, France; Research Unit EA3181, Franche-Comté University, Besançon, France
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14
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McGettigan M, Zulfiqar M, Shetty AS. Imaging of Vaginal and Vulvar Malignancy. Radiol Clin North Am 2023; 61:651-670. [PMID: 37169430 DOI: 10.1016/j.rcl.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Vaginal and vulvar malignancies are rare gynecologic malignancies but can be associated with high morbidity and mortality if undiagnosed and untreated. Advanced imaging modalities such as MRI enable assessment of the local extent of disease and evaluation for regional or distant spread. Accurate identification and description of the primary lesion and sites of involvement as well as detection and localization of suspicious lymph nodes are critical in guiding appropriate management. Additionally, radiologists should be aware of potential mimickers on imaging and the differential diagnoses for vaginal and vulvar lesions.
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15
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Yi B, Xu Q, Zhang Z, Zhang J, Xu Y, Huang L, Hu Y, Tu Q, Chen J. Implications of Persistent HPV52 and HPV58 Positivity for the Management of Cervical Lesions. Front Oncol 2022; 12:812076. [PMID: 35692793 PMCID: PMC9175636 DOI: 10.3389/fonc.2022.812076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This study aimed to compare the variability of HPV16/18/52/58 subtype infections in patients with different cervical lesions, to explore the guiding significance of persistent positive HPV subtypes 52 and 58 in the stratified management of cervical lesions, and to determine the appropriate management model. Method This study was conducted through a retrospective analysis of 244,218 patients who underwent HPV testing at the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from September 2014 to December 2020 to examine the distribution of different types of HPV infection. From March 2015 to September 2017, 3,014 patients with known HPV underwent colposcopy to analyze high-risk HPV infection for different cervical lesions. Meanwhile, from September 2014 to December 2020, 1,616 patients positive for HPV16/18/52/58 alone with normal TCT who underwent colposcopy in our hospital were retrospectively analyzed for the occurrence of cervical and vulvovaginal lesions, with colposcopic biopsy pathology results serving as the gold standard for statistical analysis. Result Analysis of 244,218 patients who had HPV tested revealed that the top 3 high-risk HPV types were HPV52, HPV58, and HPV16. Further analysis of 3,014 patients showed that 78.04% of patients referred for colposcopy had HPV16/18/52/58 alone. Among high-grade squamous intraepithelial lesions (HSIL) and cervical cancer, the most common is HPV16, followed by HPV58 and then HPV52 (p < 0.05). A total of 1,616 patients with normal TCT who were referred for colposcopy due to HPV16/18/52/58 infection were further analyzed. Based on pathological findings in lesions of HSIL and CC, HPV16 is the most common, followed by HPV58 and then HPV18 (p < 0.05). In the 1,616 patients analyzed, high-grade vulvovaginal lesions were detected, with HPV58 being the most common, followed by HPV16 and then HPV52 (p < 0.05). Conclusion 1. In patients with positive HPV58 alone and normal TCT, the indications for colposcopy may be relaxed, with particular attention paid to the possibility of vulvar and vaginal lesions.2. Patients with a positive HPV type 52 alone and normal TCT may be considered for a follow-up review and, if necessary, a colposcopy.3. The development of a more suitable HPV vaccine for the Asian population, such as HPV16/18/52/58, may better protect women's health.
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Affiliation(s)
- Baozhu Yi
- Department of Gynecology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qian Xu
- Department of Gynecology, Yiwu Maternity and Children Health Care Hospital, Jinhua, China
| | - Zhixuan Zhang
- Department of Gynecology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jinyi Zhang
- Department of Gynecology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi Xu
- Department of Gynecology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Luoqi Huang
- Department of Gynecology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yue Hu
- Department of Gynecology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Quanmei Tu
- Department of Gynecology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jingyun Chen
- Department of Gynecology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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16
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Haręża DA, Wilczyński JR, Paradowska E. Human Papillomaviruses as Infectious Agents in Gynecological Cancers. Oncogenic Properties of Viral Proteins. Int J Mol Sci 2022; 23:1818. [PMID: 35163748 PMCID: PMC8836588 DOI: 10.3390/ijms23031818] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/29/2022] [Accepted: 02/03/2022] [Indexed: 01/25/2023] Open
Abstract
Human papillomaviruses (HPVs), which belong to the Papillomaviridae family, constitute a group of small nonenveloped double-stranded DNA viruses. HPV has a small genome that only encodes a few proteins, and it is also responsible for 5% of all human cancers, including cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers. HPV types may be classified as high- and low-risk genotypes (HR-HPVs and LR-HPVs, respectively) according to their oncogenic potential. HR-HPV 16 and 18 are the most common types worldwide and are the primary types that are responsible for most HPV-related cancers. The activity of the viral E6 and E7 oncoproteins, which interfere with critical cell cycle points such as suppressive tumor protein p53 (p53) and retinoblastoma protein (pRB), is the major contributor to HPV-induced neoplastic initiation and progression of carcinogenesis. In addition, the E5 protein might also play a significant role in tumorigenesis. The role of HPV in the pathogenesis of gynecological cancers is still not fully understood, which indicates a wide spectrum of potential research areas. This review focuses on HPV biology, the distribution of HPVs in gynecological cancers, the properties of viral oncoproteins, and the molecular mechanisms of carcinogenesis.
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Affiliation(s)
- Daria A. Haręża
- Laboratory of Virology, Institute of Medical Biology of the Polish Academy of Sciences, 93-232 Lodz, Poland;
- BioMedChem Doctoral School of the University of Lodz and Lodz Institutes of the Polish Academy of Sciences, 90-237 Lodz, Poland
| | - Jacek R. Wilczyński
- Department of Surgical and Oncological Gynecology, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Edyta Paradowska
- Laboratory of Virology, Institute of Medical Biology of the Polish Academy of Sciences, 93-232 Lodz, Poland;
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17
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Zhang L, Wang Q, Zhang H, Xie Y, Sui L, Cong Q. Screening History in Vaginal Precancer and Cancer: A Retrospective Study of 2131 Cases in China. Cancer Manag Res 2021; 13:8855-8863. [PMID: 34858059 PMCID: PMC8631831 DOI: 10.2147/cmar.s335701] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/18/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To examine the screening history of vaginal intraepithelial neoplasia (VaIN) and vaginal cancer. Patients and Methods We included women with histologically confirmed VaIN or vaginal cancer by colposcopy-directed biopsy between 1 January 2019 and 31 December 2019. The results of cytology, hrHPV, colposcopic examination and history of hysterectomy were retrospectively analysed. Results A total of 26,432 colposcopies were performed during the study period, among which 2131 women (1835 [86.1%] with VaIN 1; 268 [12.6%] with VaIN 2/3; and 28 [1.3%] with vaginal cancer) were retrospectively studied. hrHPV test positivity was significantly higher than that of cytology for VaIN 1 (84.4% vs 67.3%; P < 0.001) and VaIN 2/3 (92.0% vs 79.9%; P < 0.001) but not for vaginal cancer (84.6% vs 78.6%; P = 0.73). Additionally, the concordance rates for colposcopic impression were 79.5%, 54.5%, and 92.8% for VaIN1, VaIN2/3, and vaginal cancer, respectively. All 372 patients had a history of hysterectomy, and 81.0% (282/348) of indications were related to cervical precancer and cancer. Although cytology test positivity was significantly higher in patients with hysterectomy than in patients without hysterectomy (76.2% vs 67.5%; P < 0.001), cytology combined with hrHPV can help to detect more than 95% of VaIN and vaginal cancer cases in both groups (96.2% for patients with hysterectomy and 96.5% for patients without hysterectomy). Conclusion VaIN and vaginal cancer are not rare diseases. Although cytology was sensitive (67.5%-76.2%) for detecting vaginal lesions regardless of hysterectomy, cytology combined with hrHPV improves detection accuracy up to 95% in both groups.
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Affiliation(s)
- Lu Zhang
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Qing Wang
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Hongwei Zhang
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Yu Xie
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Long Sui
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Qing Cong
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
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18
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Stein R, Ganeshan D, Gopireddy DR, Chaudhry A, Kumar S, Bande K, Bhosale P, Lall C. Current update on vaginal malignancies. Abdom Radiol (NY) 2021; 46:5353-5368. [PMID: 34338815 DOI: 10.1007/s00261-021-03228-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022]
Abstract
Primary vaginal cancers are rare and account for 1-3% of all gynecologic malignancies. There are several histological subtypes that affect a wide range of the population. Imaging plays an important role in the diagnosis, staging, and treatment planning of vaginal cancers. This article reviews the relevant anatomy, clinical findings, imaging characteristics, and recent advances in the management of vaginal malignancies.
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Affiliation(s)
- Rachel Stein
- Department of Radiology, University of Florida School of Medicine - Jacksonville, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL, 32209, USA.
| | | | - Dheeraj Reddy Gopireddy
- Department of Radiology, University of Florida School of Medicine - Jacksonville, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL, 32209, USA
| | - Ammar Chaudhry
- Department of Diagnostic Radiology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sindhu Kumar
- Department of Radiology, University of Florida School of Medicine - Jacksonville, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL, 32209, USA
| | - Karthik Bande
- Department of Radiology, University of Texas McGovern Medical School at Houston, Houston, TX, USA
| | - Priya Bhosale
- Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chandana Lall
- Department of Radiology, University of Florida School of Medicine - Jacksonville, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL, 32209, USA
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19
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Cruz-Gregorio A, Aranda-Rivera AK, Pedraza-Chaverri J. Nuclear factor erythroid 2-related factor 2 in human papillomavirus-related cancers. Rev Med Virol 2021; 32:e2308. [PMID: 34694662 DOI: 10.1002/rmv.2308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 01/04/2023]
Abstract
High-risk human papillomavirus (HR-HPV) infection is a necessary cause for the development of cervical cancer. Moreover, HR-HPV is also associated with cancers in the anus, vagina, vulva, penis and oropharynx. HR-HPVs target and modify the function of different cell biomolecules, such as glucose, amino acids, lipids and transcription factors (TF), such as p53, nuclear factor erythroid 2-related factor 2 (Nrf2), among others. The latter is a master TF that maintains redox homeostasis. Nrf2 also induces the transcription of genes associated with cell detoxification. Since both processes are critical for cell physiology, Nrf2 deregulation is associated with cancer development. Nrf2 is a crucial molecule in HPV-related cancer development but underexplored. Moreover, Nrf2 activation is also associated with resistance to chemotherapy and radiotherapy in these cancers. This review focusses on the importance of Nrf2 during HPV-related cancer development, resistance to therapy and potential therapies associated with Nrf2 as a molecular target.
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Affiliation(s)
- Alfredo Cruz-Gregorio
- Departmento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | - Ana Karina Aranda-Rivera
- Departmento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | - José Pedraza-Chaverri
- Departmento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
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20
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Matylevich OP, Trukhan HV, Zubets OI, Mavrichev SA. Twenty years' experience of primary vaginal cancer treatment at one cancer centre: does residence status matter? Ecancermedicalscience 2021; 15:1267. [PMID: 34567252 PMCID: PMC8426020 DOI: 10.3332/ecancer.2021.1267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives To study the long-term results of the treatment of patients with vaginal cancer and to examine whether there are any differences in diagnostic and survival rates between urban and rural patients. Methods The data of 70 patients with primary vaginal cancer treated at NN Alexandrov National Cancer Centre of Belarus from 2000 to 2019 were included. The median age was 64 years (range = 56–75). Morphology in 91.4% (64/70) of the cases was squamous cell cancer, in 7.1% (5/70) it was adenocarcinoma and in 1.4% (1/70) it was adenosquamous carcinoma. In total, there were 31 patients from urban and 39 from rural areas. The groups were comparable in age (61 versus 67, p = 0.104), morphology (p = 0.188) and distribution of stages: stage I in 7 and 10 patients (22.6% and 25.6%, respectively; p = 0.999), stage II in 14 and 16 patients (45.1% and 41.0%, respectively; p = 0.810), stage III in 6 and 6 patients (19.4% and 15.4%, respectively; p = 0.754) and stage IV in 4 and 7 patients (12.9% and 18.0%, respectively; p = 0.744). Results The median follow-up time was 33 months (range = 1–220). A total of 42 women died: 28 from progression of vaginal cancer and 14 from other diseases. Overall survival (OS) was 31.9 ± 6.8%, median survival was 41 months (95% CI = 0.0–105.3). Disease-specific survival (DSS) for the entire group was 54.5 ± 6.8%; median was not reached. The overall survival rate of urban women was 44.8 ± 10.6% and for rural it was 22.5 ± 8.2% (p = 0.142); DSS was 57.6 ± 10.5% and 53.0 ± 8.4% (p = 0.448), respectively. Conclusion DSS rate was 54.0 ± 6.8% and the OS rate did not exceed 31.9 ± 6.8%. Rural residence was not associated with late stage at diagnosis or receipt of treatment.
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Affiliation(s)
- Olga P Matylevich
- Gynecologic Oncology Department, NN Alexandrov National Cancer Centre of Belarus, a/g Lesnoy-2, 223040 Minsk, Belarus
| | - Hanna V Trukhan
- Department of Oncology, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus, Brovki Street, 3, build. 3, 220013 Minsk, Belarus
| | - Olga I Zubets
- Cancer Control Department, NN Alexandrov National Cancer Centre of Belarus, a/g Lesnoy-2, 223040 Minsk, Belarus
| | - Siarhei A Mavrichev
- Gynecologic Oncology Department, NN Alexandrov National Cancer Centre of Belarus, a/g Lesnoy-2, 223040 Minsk, Belarus
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21
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Rasmussen CL, Bertoli HK, Sand FL, Kjaer AK, Thomsen LT, Kjaer SK. The prognostic significance of HPV, p16, and p53 protein expression in vaginal cancer: A systematic review. Acta Obstet Gynecol Scand 2021; 100:2144-2156. [PMID: 34546565 DOI: 10.1111/aogs.14260] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Human papillomavirus (HPV), p16, and p53 have been investigated as prognostic markers in various HPV-related cancers. Within the field of vaginal cancer, however, the evidence remains sparse. In this systematic review, we have compiled the presently published studies on the prognostic significance of HPV and immunohistochemical expression of p16 and p53 among women with vaginal cancer. MATERIAL AND METHODS We conducted a systematic search of PubMed, Embase, and Cochrane Library to identify relevant studies published until April 2021. We included studies reporting survival after histologically verified vaginal cancers tested for HPV, p16, and/or p53. Survival outcomes included overall survival, disease-free survival, disease-specific survival, and progression-free survival. RESULTS We included a total of 12 studies. The vast majority of vaginal cancer cases included in each study were squamous cell carcinomas (84%-100%). Seven studies reported survival after vaginal cancer according to HPV status, and the majority of these studies found a tendency towards improved survival for women with HPV-positive vaginal cancer. Three out of four studies reporting survival according to p16 status found an improved survival among women with p16-positive vaginal cancer. For p53, only one of six studies reported an association between p53 expression and survival. CONCLUSIONS This systematic review suggests that women with HPV- and p16-positive vaginal cancer have an improved prognosis compared with those with HPV- or p16-negative vaginal cancer. Results for p53 were varied, and no conclusion could be reached. Only 12 studies could be included in the review, of which most were based on small populations. Hence, further and larger studies on the prognostic impact of HPV, p16, and p53 in vaginal cancer are warranted.
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Affiliation(s)
- Christina L Rasmussen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Hanna K Bertoli
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Freja L Sand
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Alexander K Kjaer
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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22
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Wahid M, Dar SA, Jawed A, Mandal RK, Akhter N, Khan S, Khan F, Jogiah S, Rai AK, Rattan R. Microbes in gynecologic cancers: Causes or consequences and therapeutic potential. Semin Cancer Biol 2021; 86:1179-1189. [PMID: 34302959 DOI: 10.1016/j.semcancer.2021.07.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 12/24/2022]
Abstract
Gynecologic cancers, starting in the reproductive organs of females, include cancer of cervix, endometrium, ovary commonly and vagina and vulva rarely. The changes in the composition of microbiome in gut and vagina affect immune and metabolic signaling of the host cells resulting in chronic inflammation, angiogenesis, cellular proliferation, genome instability, epithelial barrier breach and metabolic dysregulation that may lead to the onset or aggravated progression of gynecologic cancers. While microbiome in gynecologic cancers is just at horizon, certain significant microbiome signature associations have been found. Cervical cancer is accompanied with high loads of human papillomavirus, Fusobacteria and Sneathia species; endometrial cancer is reported to have presence of Atopobium vaginae and Porphyromonas species and significantly elevated levels of Proteobacteria and Firmicutes phylum bacteria, with Chlamydia trachomatis, Lactobacillus and Mycobacterium reported in ovarian cancer. Balancing microbiome composition in gynecologic cancers has the potential to be used as a therapeutic target. For example, the Lactobacillus species may play an important role in blocking adhesions of incursive pathogens to vaginal epithelium by lowering the pH, producing bacteriocins and employing competitive exclusions. The optimum or personalized balance of the microbiota can be maintained using pre- and probiotics, and fecal microbiota transplantations loaded with specific bacteria. Current evidence strongly suggest that a healthy microbiome can train and trigger the body's immune response to attack various gynecologic cancers. Furthermore, microbiome modulations can potentially contribute to improvements in immuno-oncology therapies.
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Affiliation(s)
- Mohd Wahid
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Sajad A Dar
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Arshad Jawed
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Raju Kumar Mandal
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Naseem Akhter
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Albaha University, Albaha, Saudi Arabia
| | - Saif Khan
- Department of Basic Dental and Medical Sciences, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | - Farah Khan
- Department of Biochemistry, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
| | - Sudhisa Jogiah
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
| | - Ashutosh Kumar Rai
- Department of Biochemistry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ramandeep Rattan
- Division of Gynecology Oncology, Women's Health Services, Henry Ford Hospital, Detroit, MI, USA; Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.
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23
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Du M, Wang Y, Gu D, Guo L. Identification of vital genes and pathways associated with mucosal melanoma in Chinese. Ann Diagn Pathol 2021; 50:151648. [PMID: 33189033 DOI: 10.1016/j.anndiagpath.2020.151648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 12/01/2022]
Abstract
Mucosal melanoma is a rare malignant melanoma with more aggressive and poorer outcomes. The incidence of mucosal melanoma varies greatly among different ethnic groups. We herein sought to characterize the vital genes and pathways of Chinese mucosal melanoma patients. By whole-exome sequencing in six patients with mucosal melanoma, we detected a total of 21,733 CNVs and 2372 SNPs. The CNV/SNP burden varies greatly between individuals, including recurrent CNV targeting PIK3 family, KRAS, APC and BRCA1. Significantly mutated genes were NUDT5, ZBTB18, NEURL4, ZNF430, RBM44, GAK, PCDHA13, STK38 and UBR5. Besides, FAT1 gene was identified frequently mutated in anorectal melanoma patients (3/3, 100%). Moreover, our result showed that HPV infection may be associated with mucosal melanoma. In conclusion, this study indicated that mucosal melanomas have a low SNPs burden and a high number of CNVs and expand the spectrum of mucosal melanoma variants, also provided an insight for the pathological mechanism of mucosal melanoma.
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Affiliation(s)
- Mingzhan Du
- Department of Pathology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou city, Jiangsu Province 215006, China
| | - Yuhong Wang
- Department of Pathology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou city, Jiangsu Province 215006, China
| | - Dongmei Gu
- Department of Pathology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou city, Jiangsu Province 215006, China.
| | - Lingchuan Guo
- Department of Pathology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou city, Jiangsu Province 215006, China.
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24
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Palma Dos Reis C, Correia L, Jorge AF, Félix A. Primary vaginal cancer associated with HPV 68: A case report of an unusual presentation. Int J Gynaecol Obstet 2020; 152:262-263. [PMID: 32862465 DOI: 10.1002/ijgo.13361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/16/2020] [Accepted: 08/24/2020] [Indexed: 11/05/2022]
Affiliation(s)
| | - Lúcia Correia
- Instituto Português de Oncologia Dr. Francisco Gentil, Lisboa, Portugal
| | | | - Ana Félix
- Instituto Português de Oncologia Dr. Francisco Gentil, Lisboa, Portugal
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25
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Time trends in the incidence and survival of vaginal squamous cell carcinoma and high-grade vaginal intraepithelial neoplasia in Denmark - A nationwide population-based study. Gynecol Oncol 2020; 158:734-739. [PMID: 32571683 DOI: 10.1016/j.ygyno.2020.05.683] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/31/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To describe trends in incidence of high-grade vaginal intraepithelial neoplasia (VaIN) and vaginal squamous cell carcinoma (SCC) in Denmark. For vaginal SCC, we also examine 5-year relative survival and mortality. METHODS All high-grade VaIN cases diagnosed 1997-2017 and vaginal SCCs during 1978-2017 were identified in two high-quality nationwide registers. Age-standardized incidence rates and average annual percentage change (AAPC) were assessed. For vaginal SCC, 5-year relative survival was calculated, and Cox regression was applied to study the effect of selected characteristics on mortality. RESULTS Altogether, 831 cases of high-grade VaIN and 721 vaginal SCCs were identified. The age-standardized incidence rate of high-grade VaIN showed no clear trend over time. However, when we stratified by age and divided the study period according to HPV vaccine licensure in Denmark (2006), the incidence of high-grade VaIN decreased significantly by 15.6% per year (95% CI: -23.2, -7.3%) after 2007 onwards among the youngest women (<30 years). For vaginal SCC, the incidence decreased from 0.5 (1978-1982) to 0.3 (2013-2017) per 100,000 woman-years. The 5-year relative survival improved over time and was 67.9% (95% CI: 54.9, 84.1%) in the most recent time period. Mortality was significantly associated with calendar year, age, and stage at diagnosis. CONCLUSIONS The overall incidence of high-grade VaIN showed no clear trend over time, but a significant decline was observed in women younger than 30 years after HPV vaccine licensure. The incidence of vaginal SCC was reduced by approximately 50% and survival after vaginal SCC improved over time.
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26
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Chu C, Chen K, Tan X, Lu J, Yang Y, Zhang Y, Yao K, Cao Y. Prevalence of human papillomavirus and implication on survival in Chinese penile cancer. Virchows Arch 2020; 477:667-675. [PMID: 32430598 DOI: 10.1007/s00428-020-02831-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/07/2020] [Accepted: 04/27/2020] [Indexed: 12/17/2022]
Abstract
We assessed the prevalence of HPV DNA in a large series of Chinese penile cancer and examine its association with the histological subtype, p16INK4a expression, and prognosis. We pathologically categorized 226 invasive penile squamous cell carcinomas and assessed HPV genotyping by real-time PCR and p16INK4a immunohistochemistry. The results were correlated with histopathological and clinical parameters and disease-specific survival (DSS). HPV DNA was detected in 32.7% (74/226) of penile cancer cases. The most frequent genotype was HPV 16 (64/74, 86.5%), followed by HPV 18 (6/74, 8.1%). Fifty-nine (26.1%) cases were positive for the p16INK4a expression, and p16INK4a expression had a sensitivity of 56.8% (95% CI, 45.2-68.3%) and a specificity of 88.8% (95% CI, 83.8-93.9%) for defining HPV status. HPV DNA (P = 0.019), p16INK4a (P = 0.038), age (P = 0.018), grade of differentiation (P = 0.001), lymph nodes (P < 0.001), T stage (P < 0.001), M stage (P < 0.001), and lymphovascular invasion (LVI, P = 0.001) were prognostic factors for DSS. HPV-positivity (HR 0.334; 95% CI, 0.158-0.705, P = 0.004) was still a significant prognostic factor for DSS in the multivariate Cox regression model. HPV DNA was observed in one third of Chinese penile carcinoma cases. The p16INK4a expression can indicate high-risk human papillomavirus (HR-HPV). HPV-positive penile tumors confer a survival benefit over HPV-negative tumors.
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Affiliation(s)
- Chengbiao Chu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Keming Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Xingliang Tan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Jiangli Lu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Yuanzhong Yang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - YiJun Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Kai Yao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
| | - Yun Cao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
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27
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Janecka-Widła A, Mucha-Małecka A, Majchrzyk K, Halaszka K, Przewoźnik M, Słonina D, Biesaga B. Active HPV infection and its influence on survival in head and neck squamous-cell cancer. J Cancer Res Clin Oncol 2020; 146:1677-1692. [PMID: 32372145 PMCID: PMC7256081 DOI: 10.1007/s00432-020-03218-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/11/2020] [Indexed: 01/04/2023]
Abstract
Purpose HPV is involved in the development of some head and neck squamous-cell carcinomas (HNSCC). It was suggested that only transcriptionally active virus can induce carcinogenesis, therefore, the aim of our study was to analyze the frequency of active HPV infection, virus type, and its prognostic role in HNSCC patients. Methods Status of active HPV infection was assessed for 155 HNSCC patients based on p16 expression and HPV DNA presence. Univariate and multivariate analyses with Cox proportional regression model were performed to select independent prognostic factors. Results Active HPV infection was detected in 20.65% of patients. We identified 16.0, 40.9 and 1.7% of HPV positive oral cavity, oropharyngeal, and laryngeal cancer cases, respectively. HPV16 was dominant (81.25%) followed by HPV35 (9.38%) and double infections with HPV16 and 35 (6.25%) or HPV35 and 18 (3.12%). Patients with active HPV infection demonstrated significantly higher survival than HPV negative ones (OS 80.89% vs. 37.08%, p = 0.000; DFS 93.0% vs. 53.35%, p = 0.000, respectively). Longer OS and DFS were maintained for infected patients when oropharyngeal and non-oropharyngeal cases were analyzed separately. Interestingly, all patients infected with other than HPV16 types survived 5 years without cancer progression. In the analyzed group of 155 patients the strongest independent favourable prognostic factor for both OS and DFS was HPV presence. Conclusions High prevalence of HPV-driven HNSCC (mostly within oropharynx) was detected, with HPV16 type the most frequent, followed by HPV35 and HPV18. The presence of active HPV infection improved survival of both oropharyngeal and non-oropharyngeal cancer patients and should be taken into account in treatment planning.
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Affiliation(s)
- Anna Janecka-Widła
- Department of Tumour Pathology, Maria Sklodowska-Curie Institute - Oncology Center, Cracow Branch, Cracow, Poland.
| | - Anna Mucha-Małecka
- Department of Radiotherapy, Maria Sklodowska-Curie Institute - Oncology Center, Cracow Branch, Cracow, Poland
| | - Kaja Majchrzyk
- Department of Tumour Pathology, Maria Sklodowska-Curie Institute - Oncology Center, Cracow Branch, Cracow, Poland
| | - Krzysztof Halaszka
- Department of Tumour Pathology, Maria Sklodowska-Curie Institute - Oncology Center, Cracow Branch, Cracow, Poland
| | - Marcin Przewoźnik
- Department of Tumour Pathology, Maria Sklodowska-Curie Institute - Oncology Center, Cracow Branch, Cracow, Poland
| | - Dorota Słonina
- Department of Tumour Pathology, Maria Sklodowska-Curie Institute - Oncology Center, Cracow Branch, Cracow, Poland.,Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Beata Biesaga
- Department of Tumour Pathology, Maria Sklodowska-Curie Institute - Oncology Center, Cracow Branch, Cracow, Poland.,Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
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Vashisht S, Mishra H, Mishra PK, Ekielski A, Talegaonkar S. Structure, Genome, Infection Cycle and Clinical Manifestations Associated with Human Papillomavirus. Curr Pharm Biotechnol 2020; 20:1260-1280. [PMID: 31376818 DOI: 10.2174/1389201020666190802115722] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/20/2019] [Accepted: 07/11/2019] [Indexed: 11/22/2022]
Abstract
A small, non-enveloped, obligatory parasite, Human papillomavirus (HPV) is known to be the cause of a range of malignancies. These entail benign infections like genital warts as well as malignant, life-threatening conditions such as cervical cancer. Since a very high mortality rate is associated with HPV caused cancers (cervical cancer is a 2nd leading cause of death caused due to cancer among women globally), there is an escalating need to understand and search for ways to combat such medical conditions. Under the same light, the given article provides an insight into the world of this versatile pathogen. Distinct aspects related to HPV have been discussed here. Emphasis has been laid upon the composition, function and assembly of capsid proteins (structural studies) and various genetic elements and their gene products (genomic studies). The essence of the mechanism behind the development of persistent infection and modes responsible for the transmission of the infectious particles has been briefly covered. Finally, the review outlines various infections and diseases caused by HPV with a major focus on their clinical and histological manifestations.
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Affiliation(s)
- Srishti Vashisht
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Government of NCT of Delhi, New Delhi, India
| | - Harshita Mishra
- School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Pawan K Mishra
- Department of Wood Processing, Mendel University in Brno, Brno, Czech Republic
| | - Adam Ekielski
- Department of Production Management and Engineering, Warsaw University of Life Sciences, Warsaw, Poland
| | - Sushama Talegaonkar
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Government of NCT of Delhi, New Delhi, India.,School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
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29
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Naumann RW, Hollebecque A, Meyer T, Devlin MJ, Oaknin A, Kerger J, López-Picazo JM, Machiels JP, Delord JP, Evans TR, Boni V, Calvo E, Topalian SL, Chen T, Soumaoro I, Li B, Gu J, Zwirtes R, Moore KN. Safety and Efficacy of Nivolumab Monotherapy in Recurrent or Metastatic Cervical, Vaginal, or Vulvar Carcinoma: Results From the Phase I/II CheckMate 358 Trial. J Clin Oncol 2019; 37:2825-2834. [PMID: 31487218 PMCID: PMC6823884 DOI: 10.1200/jco.19.00739] [Citation(s) in RCA: 248] [Impact Index Per Article: 49.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2019] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Nivolumab was assessed in patients with virus-associated tumors in the phase I/II CheckMate 358 trial (ClinicalTrials.gov identifier: NCT02488759). We report on patients with recurrent/metastatic cervical, vaginal, or vulvar cancers. PATIENTS AND METHODS Patients received nivolumab 240 mg every 2 weeks. Although patients with unknown human papillomavirus status were enrolled, patients known to have human papillomavirus-negative tumors were ineligible. The primary end point was objective response rate. Duration of response (DOR), progression-free survival, and overall survival were secondary end points. Safety and patient-reported outcomes were exploratory end points. RESULTS Twenty-four patients (cervical, n = 19; vaginal/vulvar, n = 5) were enrolled. Most patients had received prior systemic therapy for metastatic disease (cervical, 78.9%; vaginal/vulvar, 80.0%). Objective response rates were 26.3% (95% CI, 9.1 to 51.2) for cervical cancer and 20.0% (95% CI, 0.5 to 71.6) for vaginal/vulvar cancers. At a median follow-up of 19.2 months, median DOR was not reached (range, 23.3 to 29.5+ months; + indicates a censored observation) in the five responding patients in the cervical cohort; the DOR was 5.0 months in the single responding patient in the vaginal/vulvar cohort. Median overall survival was 21.9 months (95% CI, 15.1 months to not reached) among patients with cervical cancer. Any-grade treatment-related adverse events were reported in 12 of 19 patients (63.2%) in the cervical cohort and all five patients in the vaginal/vulvar cohort; there were no treatment-related deaths. In the cervical cohort, nivolumab treatment generally resulted in stabilization of patient-reported outcomes associated with health status and health-related quality of life. CONCLUSION The efficacy of nivolumab in patients with recurrent/metastatic cervical and vaginal or vulvar cancers is promising and warrants additional investigation. No new safety signals were identified with nivolumab treatment in this population.
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Affiliation(s)
| | | | - Tim Meyer
- UCL Cancer Institute, London, United Kingdom
| | | | - Ana Oaknin
- Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Joseph Kerger
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Jean-Pascal Machiels
- Institut Roi Albert II, Service d’Oncologie Médicale, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (IREC, Pole MIRO), UCLouvain, Brussels, Belgium
| | | | | | - Valentina Boni
- START Madrid Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - Emiliano Calvo
- START Madrid Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - Suzanne L. Topalian
- Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy and Kimmel Cancer Center, Baltimore, MD
| | | | | | - Bin Li
- Bristol-Myers Squibb, Princeton, NJ
| | | | | | - Kathleen N. Moore
- Stephenson Cancer Center at the University of Oklahoma, Oklahoma City, OK, and Sarah Cannon Research Institute, Nashville, TN
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30
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Bertoli HK, Rasmussen CL, Sand FL, Albieri V, Norrild B, Verdoodt F, Kjaer SK. Human papillomavirus and p16 in squamous cell carcinoma and intraepithelial neoplasia of the vagina. Int J Cancer 2019; 145:78-86. [PMID: 30561092 DOI: 10.1002/ijc.32078] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/07/2018] [Accepted: 12/03/2018] [Indexed: 01/22/2023]
Abstract
We estimated the overall and type-specific prevalence of human papillomavirus (HPV) and p16 overexpression in vaginal cancer and vaginal intraepithelial neoplasia (VaIN). We conducted a systematic search of PubMed, Embase and Cochrane Library to identify studies published between 1986 and 2017 using PCR-based or Hybrid Capture 2 tests to evaluate the presence of HPV DNA and/or using any method to detect p16 overexpression in VaIN, vaginal squamous cell carcinoma (VaSCC), or other types of vaginal cancer. Applying a random effects model, we estimated the pooled prevalence of HPV and p16 overexpression along with 95% confidence intervals (CIs). The I2 statistic was used to assess heterogeneity. We included 26 studies, reporting HPV prevalence and six studies evaluating p16 overexpression. The pooled HPV prevalences in VaSCC (n = 593) and VaIN (n = 1,374) were 66.7% (95% CI = 54.7-77.8) and 85.2% (95% CI = 78.2-91.0), respectively. Substantial inter-study heterogeneity was observed, and analyses stratified on geographic region, type of tissue, HPV detection method or PCR primer type did not fully explain the observed heterogeneity. The most predominant HPV type among the HPV positive VaSCC and VaIN cases was HPV16, followed by HPV33, and HPV45 (in VaIN) and HPV18, and HPV33 (in VaSCC). In pooled analyses, 89.9% (95% CI = 81.7-94.6) of HPV positive and 38.9% (95% CI = 0.9-90.0) of HPV negative vaginal cancers were positive for p16 overexpression. Our findings suggest that vaccination against HPV might prevent a substantial proportion of vaginal neoplasia and highlight the need for further studies of the possible clinical value of p16 testing in these patients.
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Affiliation(s)
- Hanna Kristina Bertoli
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Freja Laerke Sand
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Vanna Albieri
- Unit of Statistics and Pharmaco-Epidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Bodil Norrild
- Institute of Cellular and Molecular Medicine, Panum Institute, University of Copenhagen, Denmark
| | - Freija Verdoodt
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Eleutério J, de Freitas FMM, Oliveira DN, Moreira DF, Pessoa MS. Poorly differentiated vaginal adenocarcinoma with aggressive behavior-Pap smear findings. Diagn Cytopathol 2017; 45:1055-1056. [PMID: 28670843 DOI: 10.1002/dc.23774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 04/26/2017] [Accepted: 06/12/2017] [Indexed: 11/06/2022]
Abstract
Vaginal carcinoma is a rare condition. In this report, we describe a case of a poorly differentiated aggressive adenocarcinoma in a woman with a three month history of vaginal bleeding and a negative Pap smear done six months prior to her consultation. Specular examination showed a normal cervix, but there was a bleeding ulcer (2 cm in diameter) in the upper third of the vagina. Cytology revealed poorly differentiated atypical cells, and the biopsy established a diagnosis of vaginal adenocarcinoma with little differentiation. Within two months, the patient died without diagnosis of a primary tumor site other than the vagina.
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Affiliation(s)
- José Eleutério
- Department of Maternal and Child Health, Federal University of Ceará, Fortaleza (CE), Brazil
| | | | - Denise Nunes Oliveira
- Master student of the Program in Collective Health at the University of Fortaleza, Brazil
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Matsuoka M, Yamamoto R, Tsuji N, Terakawa K, Nagano T. Abdominal radical trachelectomy for vaginal cancer - A case report. Gynecol Oncol Rep 2017; 21:45-47. [PMID: 28664182 PMCID: PMC5479951 DOI: 10.1016/j.gore.2017.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/02/2017] [Accepted: 06/04/2017] [Indexed: 11/24/2022] Open
Abstract
Vaginal cancer is most common in elderly woman and very rare in young woman. Stage I vaginal cancer is treated with surgery and radiotherapy. Vaginal cancer in a young patient was treated by intra-arterial chemotherapy followed by abdominal radical trachelectomy.
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Affiliation(s)
- Mari Matsuoka
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Reserch Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - Rumiko Yamamoto
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Reserch Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - Natsuki Tsuji
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Reserch Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - Koichi Terakawa
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Reserch Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - Tadayoshi Nagano
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Reserch Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
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Zhu Y, Wang Y, Hirschhorn J, Welsh KJ, Zhao Z, Davis MR, Feldman S. Human Papillomavirus and Its Testing Assays, Cervical Cancer Screening, and Vaccination. Adv Clin Chem 2017. [PMID: 28629588 DOI: 10.1016/bs.acc.2017.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Human papillomavirus (HPV) was found to be the causative agent for cervical cancer in the 1980s with almost 100% of cervical cancer cases testing positive for HPV. Since then, many studies have been conducted to elucidate the molecular basis of HPV, the mechanisms of carcinogenesis of the virus, and the risk factors for HPV infection. Traditionally, the Papanicolaou test was the primary screening method for cervical cancer. Because of the discovery and evolving understanding of the role of HPV in cervical dysplasia, HPV testing has been recommended as a new method for cervical cancer screening by major professional organizations including the American Cancer Society, American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology. In order to detect HPV infections, many sensitive and specific HPV assays have been developed and used clinically. Different HPV assays with various principles have shown their unique advantages and limitations. In response to a clear causative relationship between high-risk HPV and cervical cancer, HPV vaccines have been developed which utilize virus-like particles to create an antibody response for the prevention of HPV infection. The vaccines have been shown in long-term follow-up studies to be effective for up to 8 years; however, how this may impact screening for vaccinated women remains uncertain. In this chapter, we will review the molecular basis of HPV, its pathogenesis, and the epidemiology of HPV infection and associated cervical cancer, discuss the methods of currently available HPV testing assays as well as recent guidelines for HPV screening, and introduce HPV vaccines as well as their impact on cervical cancer screening and treatments.
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Affiliation(s)
- Yusheng Zhu
- Pennsylvania State University Hershey Medical Center, Hershey, PA, United States.
| | - Yun Wang
- Medical University of South Carolina, Charleston, SC, United States
| | - Julie Hirschhorn
- Pennsylvania State University Hershey Medical Center, Hershey, PA, United States
| | - Kerry J Welsh
- National Institute of Health, Bethesda, MD, United States
| | - Zhen Zhao
- National Institute of Health, Bethesda, MD, United States
| | - Michelle R Davis
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah Feldman
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Chang JH, Jang WI, Kim YB, Kim JH, Kim YS, Kim YS, Park W, Kim J, Yoon WS, Kim JY, Kim HJ. Definitive treatment of primary vaginal cancer with radiotherapy: multi-institutional retrospective study of the Korean Radiation Oncology Group (KROG 12-09). J Gynecol Oncol 2016; 27:e17. [PMID: 26768782 PMCID: PMC4717222 DOI: 10.3802/jgo.2016.27.e17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 09/29/2015] [Accepted: 10/07/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the outcome of the treatment of primary vaginal cancer using definitive radiotherapy (RT) and to evaluate the prognostic factors of survival. METHODS The medical records of nine institutions were retrospectively reviewed to find the patients with vaginal cancer treated with definitive RT with or without chemotherapy. A total of 138 patients met the inclusion criteria. None had undergone curative excision. RESULTS The median follow-up time of the survivors was 77.6 months and the median survival time was 46.9 months. The 5-year overall survival, cancer-specific survival (CSS), and progression-free survival (PFS) rates were 68%, 80%, and 68.7%, respectively. In the survival analysis, the multivariate analysis showed that a lower the International Federation of Gynecology and Obstetrics (FIGO) stage and prior hysterectomy were favorable prognostic factors of CSS, and a lower FIGO stage and diagnosed prior to year 2000 were favorable prognostic factors of PFS. In the subgroup analysis of the patients with available human papillomavirus (HPV) results (n=27), no statistically significant relationship between the HPV status and recurrence or survival was found. Grade 3 or 4 acute and late toxicity were present in 16 and 9 patients, respectively. The FIGO stage and the tumor size were predictors of severe late toxicity. CONCLUSION The data clearly showed that a higher FIGO stage was correlated with a worse survival outcome and higher severe late toxicity. Therefore, precise RT and careful observation are crucial in advanced vaginal cancer. In this study, the HPV status was not related to the survival outcome, but its further investigation is needed.
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Affiliation(s)
- Ji Hyun Chang
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won Il Jang
- Department of Radiation Oncology, Korea Institute of Radiological & Medical Science, Seoul, Korea
| | - Yong Bae Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Hee Kim
- Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Young Seok Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yeon Sil Kim
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Juree Kim
- Department of Radiation Oncology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Won Sup Yoon
- Department of Radiation Oncology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Joo-Young Kim
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Hak Jae Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
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A Common Clinical Dilemma: Management of Abnormal Vaginal Cytology and Human Papillomavirus Test Results. J Low Genit Tract Dis 2016; 20:119-25. [PMID: 26901279 DOI: 10.1097/lgt.0000000000000185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Vaginal cancer is an uncommon cancer of the lower genital tract, and standardized screening is not recommended. Risk factors for vaginal cancer include a history of other lower genital tract neoplasia or cancer, smoking, immunosuppression, and exposure to diethylstilbestrol in utero. Although cervical cancer screening after total hysterectomy for benign disease is not recommended, many women inappropriately undergo vaginal cytology and/or human papillomavirus (HPV) tests, and clinicians are faced with managing their abnormal results. Our objectives were to review the literature on vaginal cytology and high-risk HPV (hrHPV) testing and to develop guidance for the management of abnormal vaginal screening tests. MATERIALS AND METHODS An electronic search of the PubMed database through 2015 was performed. Articles describing vaginal cytology or vaginal hrHPV testing were reviewed, and diagnostic accuracy of these tests when available was noted. RESULTS The available literature was too limited to develop evidence-based recommendations for managing abnormal vaginal cytology and hrHPV screening tests. However, the data did show that (1) the risk of vaginal cancer in women after hysterectomy is extremely low, justifying the recommendation against routine screening, and (2) in women for whom surveillance is recommended, e.g., women posttreatment for cervical precancer or cancer, hrHPV testing may be useful in identification of vaginal cancer precursors. CONCLUSIONS Vaginal cancer is rare, and asymptomatic low-risk women should not be screened. An algorithm based on expert opinion is proposed for managing women with abnormal vaginal test results.
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36
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Khan MJ, Massad LS, Kinney W, Gold MA, Mayeaux EJ, Darragh TM, Castle PE, Chelmow D, Lawson HW, Huh WK. A common clinical dilemma: Management of abnormal vaginal cytology and human papillomavirus test results. Gynecol Oncol 2016; 141:364-370. [PMID: 26915529 DOI: 10.1016/j.ygyno.2015.11.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/15/2015] [Accepted: 11/20/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Vaginal cancer is an uncommon cancer of the lower genital tract, and standardized screening is not recommended. Risk factors for vaginal cancer include a history of other lower genital tract neoplasia or cancer, smoking, immunosuppression, and exposure to diethylstilbestrol in utero. Although cervical cancer screening after total hysterectomy for benign disease is not recommended, many women inappropriately undergo vaginal cytology and/or human papillomavirus (hrHPV) tests, and clinicians are faced with managing their abnormal results. Our objective is to review the literature on vaginal cytology and hrHPV testing and to develop guidance for the management of abnormal vaginal screening tests. METHODS An electronic search of the PubMed database through 2015 was performed. Articles describing vaginal cytology or vaginal hrHPV testing were reviewed, and diagnostic accuracy of these tests when available was noted. RESULTS The available literature was too limited to develop evidence-based recommendations for managing abnormal vaginal cytology and hrHPV screening tests. However, the data did show that 1) the risk of vaginal cancer in women after hysterectomy is extremely low, justifying the recommendation against routine screening, and 2) in women for whom surveillance is recommended, e.g. women post-treatment for cervical precancer or cancer, hrHPV testing may be useful in identification of vaginal cancer precursors. CONCLUSION Vaginal cancer is rare, and asymptomatic low-risk women should not be screened. An algorithm based on expert opinion is proposed for managing women with abnormal vaginal test results.
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Affiliation(s)
- Michelle J Khan
- Division of Women's Reproductive Healthcare, Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
| | - L Stewart Massad
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - Walter Kinney
- Department of Women's Health, The Permanente Medical Group, Sacramento, CA, USA
| | - Michael A Gold
- Tulsa Cancer Institute, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA
| | - E J Mayeaux
- Department of Family and Preventive Medicine, Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Teresa M Darragh
- Department of Clinical Pathology, University of California, San Francisco, CA, USA
| | - Philip E Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David Chelmow
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA
| | - Herschel W Lawson
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Warner K Huh
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
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Fu S, Shi N, Wheler J, Naing A, Janku F, Piha-Paul S, Gong J, Hong D, Tsimberidou A, Zinner R, Subbiah V, Hou MM, Ramirez P, Ramondetta L, Lu K, Meric-Bernstam F. Characteristics and outcomes for patients with advanced vaginal or vulvar cancer referred to a phase I clinical trials program: the MD Anderson cancer center experience. GYNECOLOGIC ONCOLOGY RESEARCH AND PRACTICE 2015; 2:10. [PMID: 27231570 PMCID: PMC4880813 DOI: 10.1186/s40661-015-0018-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/03/2015] [Indexed: 11/16/2022]
Abstract
Background Early-stage vaginal and vulvar cancer can be cured. But outcomes of patients with metastatic disease are poor. Thus, new therapeutic strategies are urgently required. Methods In this retrospective study, we analyzed the clinical outcomes of consecutive patients with metastatic vaginal or vulvar cancer who were referred to a phase I trial clinic between January 2006 and December 2013. Demographic and clinical data were obtained from patients’ electronic medical records. Results Patients with metastatic vaginal (n = 16) and vulvar (n = 20) cancer who were referred for phase I trial therapy had median overall survival durations of 6.2 and 4.6 months, respectively. Among those who underwent therapy (n = 27), one experienced a partial response and three experienced stable disease for at least 6 months. Patients with a body mass index ≥30 had a significantly longer median overall survival duration than did those with a body mass index <30 (13.2 months versus 4.4 months, p = 0.04). Preliminary data revealed differences in molecular profiling between patients with advanced vaginal cancer and those with advanced vaginal cancer. Conclusions Metastatic vaginal and vulvar cancers remain to be difficult-to-treat diseases with poor clinical outcomes. The currently available phase I trial agents provided little meaningful clinical benefits. Understanding these tumors’ molecular mechanisms may allow us to develop more effective therapeutic strategies than are currently available regimens.
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Affiliation(s)
- Siqing Fu
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Naiyi Shi
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Jennifer Wheler
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Aung Naing
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Filip Janku
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Sarina Piha-Paul
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Jing Gong
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - David Hong
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Apostolia Tsimberidou
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Ralph Zinner
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Ming-Mo Hou
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Pedro Ramirez
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lois Ramondetta
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Karen Lu
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
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Serrano B, de Sanjosé S, Tous S, Quiros B, Muñoz N, Bosch X, Alemany L. Human papillomavirus genotype attribution for HPVs 6, 11, 16, 18, 31, 33, 45, 52 and 58 in female anogenital lesions. Eur J Cancer 2015; 51:1732-41. [PMID: 26121913 DOI: 10.1016/j.ejca.2015.06.001] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/26/2015] [Accepted: 06/01/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Human papillomavirus (HPV) vaccines can potentially control cervical cancer and help to reduce other HPV-related cancers. We aimed to estimate the relative contribution (RC) of the nine types (HPVs 16/18/31/33/45/52/58/6/11) included in the recently approved 9-valent HPV vaccine in female anogenital cancers and precancerous lesions (cervix, vulva, vagina and anus). METHODS Estimations were based on an international study designed and coordinated at the Catalan Institute of Oncology (Barcelona-Spain), including information on 10,575 invasive cervical cancer (ICC), 1709 vulvar, 408 vaginal and 329 female anal cancer cases and 587 Vulvar Intraepitelial Neoplasia grade 2/3 (VIN2/3), 189 Vaginal Intraepitelial Neoplasia grade 2/3 (VaIN2/3) and 29 Anal Intraepitelial Neoplasia grade 2/3 (AIN2/3) lesions. Consecutive histologically confirmed paraffin-embedded cases were obtained from hospital pathology archives from 48 countries worldwide. HPV DNA-detection and typing was performed by SPF10-DEIA-LiPA25 system and RC was expressed as the proportion of type-specific cases among HPV positive samples. Multiple infections were added to single infections using a proportional weighting attribution. RESULTS HPV DNA prevalence was 84.9%, 28.6%, 74.3% and 90.0% for ICC, vulvar, vaginal and anal cancers, respectively, and 86.7%, 95.8% and 100% for VIN2/3, VaIN2/3 and AIN2/3, respectively. RC of the combined nine HPV types was 89.5% (95% confidence interval (CI): 88.8-90.1)-ICC, 87.1% (83.8-89.9)-vulvar, 85.5% (81.0-89.2)-vaginal, 95.9% (93.0-97.9)-female anal cancer, 94.1% (91.7-96.0)-VIN2/3, 78.7% (71.7-84.2)-VaIN2/3 and 86.2% (68.3-96.1)-AIN2/3. HPV16 was the most frequent type in all lesions. Variations in the RC of HPVs 31/33/45/52/58 by cancer site were observed, ranging from 7.8% (5.0-11.4)-female anal cancer to 20.5% (16.1-25.4)-vaginal cancer. CONCLUSIONS The addition of HPVs 31/33/45/52/58 to HPV types included in current vaccines (HPV16/18) could prevent almost 90% of HPV positive female anogenital lesions worldwide. Taking into account that most HPV-related cancers are ICC ones, the 9-valent HPV vaccine could potentially avoid almost 88% of all female anogenital cancers.
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Affiliation(s)
- Beatriz Serrano
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Silvia de Sanjosé
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Sara Tous
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Beatriz Quiros
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Nubia Muñoz
- National Institute of Cancer, Bogotá, Colombia.
| | - Xavier Bosch
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Laia Alemany
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Gardner CS, Sunil J, Klopp AH, Devine CE, Sagebiel T, Viswanathan C, Bhosale PR. Primary vaginal cancer: role of MRI in diagnosis, staging and treatment. Br J Radiol 2015; 88:20150033. [PMID: 25966291 DOI: 10.1259/bjr.20150033] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Primary carcinoma of the vagina is rare, accounting for 1-3% of all gynaecological malignancies. MRI has an increasing role in diagnosis, staging, treatment and assessment of complications in gynaecologic malignancy. In this review, we illustrate the utility of MRI in patients with primary vaginal cancer and highlight key aspects of staging, treatment, recurrence and complications.
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Affiliation(s)
- C S Gardner
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Sunil
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A H Klopp
- 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C E Devine
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - T Sagebiel
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Viswanathan
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P R Bhosale
- 1 Department of Diagnostic Radiology, Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Saraiya M, Unger ER, Thompson TD, Lynch CF, Hernandez BY, Lyu CW, Steinau M, Watson M, Wilkinson EJ, Hopenhayn C, Copeland G, Cozen W, Peters ES, Huang Y, Saber MS, Altekruse S, Goodman MT. US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. J Natl Cancer Inst 2015; 107:djv086. [PMID: 25925419 DOI: 10.1093/jnci/djv086] [Citation(s) in RCA: 507] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 03/03/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This study sought to determine the prevaccine type-specific prevalence of human papillomavirus (HPV)-associated cancers in the United States to evaluate the potential impact of the HPV types in the current and newly approved 9-valent HPV vaccines. METHODS The Centers for Disease Control and Prevention partnered with seven US population-based cancer registries to obtain archival tissue for cancers diagnosed from 1993 to 2005. HPV testing was performed on 2670 case patients that were fairly representative of all participating cancer registry cases by age and sex. Demographic and clinical data were evaluated by anatomic site and HPV status. Current US cancer registry data and the detection of HPV types were used to estimate the number of cancers potentially preventable through vaccination. RESULTS HPV DNA was detected in 90.6% of cervical, 91.1% of anal, 75.0% of vaginal, 70.1% of oropharyngeal, 68.8% of vulvar, 63.3% of penile, 32.0% of oral cavity, and 20.9% of laryngeal cancers, as well as in 98.8% of cervical cancer in situ (CCIS). A vaccine targeting HPV 16/18 potentially prevents the majority of invasive cervical (66.2%), anal (79.4%), oropharyngeal (60.2%), and vaginal (55.1%) cancers, as well as many penile (47.9%), vulvar (48.6%) cancers: 24 858 cases annually. The 9-valent vaccine also targeting HPV 31/33/45/52/58 may prevent an additional 4.2% to 18.3% of cancers: 3944 cases annually. For most cancers, younger age at diagnosis was associated with higher HPV 16/18 prevalence. With the exception of oropharyngeal cancers and CCIS, HPV 16/18 prevalence was similar across racial/ethnic groups. CONCLUSIONS In the United States, current vaccines will reduce most HPV-associated cancers; a smaller additional reduction would be contributed by the new 9-valent vaccine.
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Affiliation(s)
- Mona Saraiya
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA).
| | - Elizabeth R Unger
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Trevor D Thompson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Charles F Lynch
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Brenda Y Hernandez
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Christopher W Lyu
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Martin Steinau
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Meg Watson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Edward J Wilkinson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Claudia Hopenhayn
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Glenn Copeland
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Wendy Cozen
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Edward S Peters
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Youjie Huang
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Maria Sibug Saber
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Sean Altekruse
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
| | - Marc T Goodman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (MSa, TDT, MW) and Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (ERU, MSt), Centers for Disease Control and Prevention, Atlanta, GA; University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI (MTG, BYH); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (CFL); Departments of Preventive Medicine (WC) and Pathology (WC, MSS), University of Southern California, Los Angeles, CA; Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA (ESP); Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL (EJW); Michigan Department of Community Health, Lansing, MI (GC); Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY (CH); Florida Department of Health, Tallahassee, FL (YH); Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD (SFA); Battelle Memorial Institute, Durham, NC (CWL); National Cancer Institute (SA)
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Large contribution of human papillomavirus in vaginal neoplastic lesions: A worldwide study in 597 samples. Eur J Cancer 2014; 50:2846-54. [DOI: 10.1016/j.ejca.2014.07.018] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 07/16/2014] [Accepted: 07/18/2014] [Indexed: 01/27/2023]
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HPV in genital cancers (at the exception of cervical cancer) and anal cancers. Presse Med 2014; 43:e423-8. [PMID: 25455637 DOI: 10.1016/j.lpm.2014.10.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 09/30/2014] [Accepted: 10/02/2014] [Indexed: 02/08/2023] Open
Abstract
Human papillomavirus (HPV) infection has been firmly established as a central and necessary cause of invasive cervical cancer and it has been etiologically linked to other anogenital (vulva, vagina, anus and penis) and head and neck cancers, particularly oropharyngeal. Although being rare, the incidence of some of these cancers in some countries has increased in the last decades. HPV-related anogenital tumors share many risk factors with cervical cancer. The HPV aetiological contribution differs in each anatomical location reflecting differences in the natural history and viral tissue tropism. The highest prevalence of HPV DNA in cancers other than cervix has been described for anal, followed by vagina, penile and vulvar cancers. HPV16 has been described as the most common type detected in all cancer sites with different contributions being the highest in anal carcinoma (around 80% of HPV DNA positive anal cancers) and the lowest in vaginal cancers with a contribution similar to that found in cervical cancers (around 60%). Current HPV vaccines have already demonstrated their efficacy in preventing anogenital pre-neoplastic lesions caused by vaccine HPV types. HPV-based prevention tools like HPV vaccination and to a lesser extend screening (e.g. for anal cancer) can be useful measures for reducing the burden of these anogenital cancers.
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Beltrão M, Wanderley MSO, de Santana NA, Bruneska D, de Lima Filho JL. Site of infections associated with human papillomavirus. Arch Gynecol Obstet 2014; 291:481-91. [PMID: 25245668 DOI: 10.1007/s00404-014-3480-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/12/2014] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Human papillomavirus (HPV) is the most clinically common sexually transmitted infection due to its carcinogenic power and the high number of lesions that it causes at different sites of the human body. MATERIAL AND METHODS Genital tract organs are the most common sites where the virus can be found, but by increasing the sensitivity of diagnostic technique, it is possible to identify viral presence in different regions of the body such as the stomach, the lung, and the urinary tract. These findings break with the traditional HPV skin/genital tropic profile and demonstrate that the virus is capable of infecting a wide variety of cells, tissues, and organs or can, at least, survive in these areas. The widespread presence of the HPV in the human body, often in latent form, led us to consider the hypothesis that HPV latency may be associated with no disease. CONCLUSION This observation raises further questions about the possibility of the virus not causing disease in specific sites of the human body, but rather, behaving like a commensal/opportunistic microorganism.
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Affiliation(s)
- Monique Beltrão
- Laboratory of Imunopathology Keizo Asami (LIKA), Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego, 1235 Cidade Universitária, Recife, PE, CEP 50670-901, Brazil,
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