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Metz CK, Skof AS, Henrich W, Sehouli J, Kaufmann AM, Rohr I. Human papillomavirus prevalence in pregnant women living with human immunodeficiency virus infection: a scoping review of the literature. J Perinat Med 2024; 52:1-13. [PMID: 37540166 DOI: 10.1515/jpm-2023-0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/01/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Studies already pointed out the increased risk of human papillomavirus (HPV) positivity and the implied risk of cervical dysplasia and even cervical carcinoma in pregnant women with human immunodeficiency virus (HIV) infection. Nevertheless, due to less data there is still no standardised and expanded screening for this high-risk group. CONTENT Two online databases (PubMed, EMBASE) were used to identify eligible studies. Results are shown in percentages. Wherever useful the arithmetic mean was calculated. SUMMARY Seven studies were included. Pregnant WLWH showed HPV prevalence between 34 and 98.4 %. Different sensitivity and specificity among PCR methods for HPV detection could be a reason for the large range concerning HPV prevalence. Risk factors like Age, Smoking, Sexuality, HIV status and education level should always be taken into account. Association between HPV prevalence and level of CD4 cells or HIV virus load was seen. In which way use of Antiretroviral Therapy (ART) could decries the risk for HPV infections is still discussed. When cytology was performed only few high-grade squamous intraepithelial lesion (HSIL) were found. OUTLOOK Standardisation and expansion of preventive screening for cervical dysplasia and carcinoma for pregnant WLWH is necessary. Then better comparability of the data will also be achieved.
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Affiliation(s)
- Charlotte Kalinka Metz
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Anna Sophie Skof
- Laboratory for Gynaecological Tumorimmunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Wolfgang Henrich
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Jalid Sehouli
- Laboratory for Gynaecological Tumorimmunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
- Department of Gynecology with Center for Oncological Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Andreas M Kaufmann
- Laboratory for Gynaecological Tumorimmunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Irena Rohr
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
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Freisleben M, Petzel A, Jülicher A, Jonas A, Betzler J, Choly N, Pashayeva E, Porthun J, Welcker T, Schneider V, Kaufmann AM, Schneider A. Loop Excision for Precancers of the Uterine Cervix: Local or General Anaesthetic? Geburtshilfe Frauenheilkd 2023; 83:1263-1273. [PMID: 37808260 PMCID: PMC10556877 DOI: 10.1055/a-2150-0835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/05/2023] [Indexed: 10/10/2023] Open
Abstract
Aim In Germany, treatment of HSIL or AIS of the uterine cervix by loop excision is performed almost exclusively under general anaesthesia (GA). International studies and guidelines show high acceptance of local anaesthesia (LA) due to hermeneutic, medical, and economic factors. We performed an observational comparative study aiming to prove advantages of local anaesthesia within the German health system. Patients and Methods In a prospective observational study, patients diagnosed with HSIL or AIS of the uterine cervix were treated at the Institute for Cytology and Dysplasia, Berlin, by loop excision in 2021. We started with a feasibility study : 303 patients diagnosed with HSIL/AIS of the uterine cervix and her colposcopist answered an electronic questionnaire with respect to loop excision under LA. Since we found a high acceptance for LA in patients and colposcopists, we initiated a comparative study LA vs. GA: 322 patients underwent loop excision and selected their mode of anaesthesia: n = 206 LA vs. n = 116 GA. 114 patients of the feasibility study had to undergo loop excision and became part of the comparative study (n = 79 for the LA group, n = 35 for the GA group). All patients received a standardised questionnaire to document their pain score within 24 h after treatment on a visual analogue scale, i.e. VAS, between 0 and 100. 178 patients of the LA group and 80 patients of the GA group completed and returned the questionnaire and form the cohort for our comparison of LA vs. GA. With 191 of these 258 patients, i.e. 74%, a telephone survey was performed to ask for patient satisfaction and the rates of recurrence after a mean interval of 1 year post surgery. We postulate that there will be no clinically relevant significant difference in satisfaction and postoperative pain between patients in the LA group and the GA group. Results In the feasibility study , 90% (272 of 303) of patients diagnosed with HSIL or AIS were considered eligible for LA by their colposcopists. 75% (227 of 303) of patients were open to loop excision under LA. In the comparative study , 63 of 206 women of the LA group were interviewed preoperatively: 89% would accept a pain score above 20 during the procedure, 33% a pain score above 50 and 11% of max. 20. Postoperatively, the median VAS pain score for loop excision under local anaesthesia was 13.1 in 178 patients, and pain during injection of local anaesthesia was 20.9 (p < 0.001). The VAS pain score 20 minutes post surgery did not differ significantly between 178 patients after local anaesthesia versus 80 patients after general anaesthesia (p = 0.09). The surgeons estimated the patient's pain significantly less than the patients themselves with an underestimate of -14.63 points on the VAS (p < 0.001). Within 7 days following loop excision under LA, 95.5% of 178 patients would choose local anaesthesia as their preferred method for a potential repeat loop excision, 8.8% of which would like additional painkillers, and 4.5% would choose general anaesthesia.In a telephone follow-up survey of 133 women from the LA group after a mean of 12 months post surgery, 97% were "satisfied" or "very satisfied" with the treatment carried out. For patient satisfaction and postoperative pain, no clinically relevant significant difference was seen between the LA and the GA group.The rate of secondary bleeding (6.7% vs. 8.1%, p = 0.72), recurrence of HSIL/AIS (3.6% vs. 5.2%, p = 0.62), and the distribution of the histopathological R status (R0 89.5% vs. 81.1%, p = 0.73; R1 5.3% vs.12.2%, p = 0.57, Rx 4.1% vs. 5.4%, p = 0.65) showed no significant difference when comparing the LA group versus the GA group. Conclusion Following loop excision under local anaesthesia, more than 95% of patients would choose this method again for repeat surgery. One year post surgery, 97% of the patients were "satisfied" or "very satisfied" with the treatment under local anaesthesia. Offering local anaesthesia for loop excision to patients should be mandatory and included in current guidelines.
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Affiliation(s)
| | - Anja Petzel
- Institut für Zytologie und Dysplasie, Berlin, Germany
| | - Anne Jülicher
- Institut für Zytologie und Dysplasie, Berlin, Germany
| | - Anna Jonas
- Institut für Zytologie und Dysplasie, Berlin, Germany
| | | | - Natalia Choly
- Institut für Zytologie und Dysplasie, Berlin, Germany
| | | | - Jan Porthun
- NTNU – Technisch-Naturwissenschaftliche Universität Norwegens, Campus Gjøvik, Gjøvik, Norway
| | | | | | - Andreas M. Kaufmann
- Klinik für Gynäkologie, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, CVK, Berlin, Germany
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Loenenbach A, Schönfeld V, Takla A, Wiese-Posselt M, Marquis A, Thies S, Sand M, Kaufmann AM, Wichmann O, Harder T. Human papillomavirus prevalence and vaccine effectiveness in young women in Germany, 2017/2018: results from a nationwide study. Front Public Health 2023; 11:1204101. [PMID: 37719724 PMCID: PMC10501861 DOI: 10.3389/fpubh.2023.1204101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
Background Infections with human papillomaviruses (HPV) are sexually transmitted and can cause cancer. In Germany, vaccination against HPV is recommended for girls and boys aged 9-17 years. We aimed to investigate HPV DNA prevalence, genotype distribution and vaccine effectiveness (VE) in women aged 20-25 years 10 years after the introduction of HPV vaccination in Germany (2018-2019), and compared these data to an equally designed study from 2010-2012. Methods Seventy six geographical clusters were randomly selected, followed by random selection of 61 women aged 20-25 years per cluster. Participants performed cervicovaginal self-sampling and answered questions on demographics, sexual behaviour and HPV vaccination. Samples were tested for 18 high risk and nine low risk HPV genotypes. We performed chi-square tests, Fisher's exact test, unpaired Student's t-test and proportion t-test, and calculated crude and adjusted prevalence ratios (PR) and 95% CIs. Results Of 7,858 contacted women a total of 1,226 agreed to participate. Of these, 94 women were positive for HPV types 16 and/or 18. HPV16 prevalence was 7.0% (95% CI 5.6-8.6) and HPV18 prevalence was 0.8% (95% CI 0.4-1.5). HPV6 and HPV11 were rare with only five (0.4%; 0.1-0.9) and one (0%; 95% CI 0.0-0.5) positive tests. Seven hundred fifty-seven women (62%) had received at least one HPV vaccine dose and 348 (28%) were vaccinated as currently recommended. Confounder-adjusted VE was 46.4% (95% CI 4.2-70.1) against HPV16/18 infection and 49.1% (95% CI 8.2-71.8) against infection with at least one HPV genotype covered by the quadrivalent HPV vaccine. Compared with the 2010-2012 study results, HPV16/18 prevalence dropped from 22.5% (95% CI 19.0-26.3) to 10.3% (95% CI 7.5-13.9; p < 0.0001) in unvaccinated participants. Conclusion Vaccine-covered HPV genotypes were rare among 20-25 years old women in Germany and decreased compared to the time point shortly after the start of the HPV vaccination program. HPV prevalence of almost all vaccine-covered genotypes was strongly reduced in vaccinated participants. A decrease of HPV16 and HPV18 was even observed in unvaccinated participants, compared to 2010-2012 data, suggesting indirect protection of unvaccinated women. Low VE against HPV16/18 and HPV6/11/16/18 in our study might be attributable to study design in combination with the endpoint selection of (mainly transient) HPV DNA positivity.
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Affiliation(s)
| | | | - Anja Takla
- Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Miriam Wiese-Posselt
- Immunization Unit, Robert Koch-Institute, Berlin, Germany
- Institute of Hygiene and Environmental Medicine, Charité—Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Adine Marquis
- Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Sarah Thies
- Department of Gynecology, HPV Research Laboratory, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Sand
- GESIS Leibniz Institute for Social Sciences, Mannheim, Germany
| | - Andreas M. Kaufmann
- Department of Gynecology, HPV Research Laboratory, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Thomas Harder
- Immunization Unit, Robert Koch-Institute, Berlin, Germany
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Xu Q, Dong H, Wang Z, Zhang P, Albers AE, Kaufmann AM, Zheng ZM, Qian X. Integration and viral oncogene expression of human papillomavirus type 16 in oropharyngeal squamous cell carcinoma and gastric cancer. J Med Virol 2023; 95:e28761. [PMID: 37212316 DOI: 10.1002/jmv.28761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/10/2023] [Accepted: 04/15/2023] [Indexed: 05/23/2023]
Abstract
Persistent high-risk human papillomavirus (HR-HPV) infections cause cervical cancer and a fraction of head and neck cancer. To investigate whether HR-HPV infection might be also involved in the development of gastric cancer (GC), we developed a platform utilizing a rolling circle amplification (RCA)-based nested L1 polymerase chain reaction with Sanger sequencing to genotype the HPV DNA in cancer tissues of 361 GC and 89 oropharyngeal squamous cell carcinomas (OPSCC). HPV transcriptional activity was determined by E6/E7 mRNA expression and a 3' rapid amplification of cDNA ends was performed to identify HPV integration and expression of virus-host fusion transcripts. Ten of 361 GC, 2 of 89 OPSCC, and 1 of 22 normal adjacent tissues were HPV L1 DNA-positive. Five of the 10 HPV-positive GC were genotyped as HPV16 by sequencing and 1 of 2 GC with RCA/nested HPV16 E6/E7 DNA detection exhibited HPV16 E6/E7 mRNA. Two OPSCC displayed HPV16 L1 DNA and E6/E7 mRNA, of which 1 OPSCC tissue showed virus-host RNA fusion transcripts from an intron region of KIAA0825 gene. Together, our data reveal viral oncogene expression and/or integration in GC and OPSCC and a possible etiology role of HPV infections in gastric carcinogenesis.
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Affiliation(s)
- Qiang Xu
- Zhejiang Cancer Research Institute, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Haoru Dong
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
- Postgraduate Education Base, Wenzhou Medical University, Wenzhou, China
| | - Zhiyu Wang
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
- Postgraduate Education Base, Wenzhou Medical University, Wenzhou, China
| | - Pei Zhang
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Andreas E Albers
- Department of Clinical Medicine, Oto-Rhino-Laryngology, Medical School Berlin, Berlin, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Zhi-Ming Zheng
- Tumor Virus RNA Biology Section, HIV Dynamics and Replication Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, Maryland, USA
| | - Xu Qian
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
- Postgraduate Education Base, Wenzhou Medical University, Wenzhou, China
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5
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Teka B, Yoshida-Court K, Firdawoke E, Chanyalew Z, Gizaw M, Addissie A, Mihret A, Colbert LE, Napravnik TC, El Alam MB, Lynn EJ, Mezzari M, Anuja J, Kantelhardt EJ, Kaufmann AM, Klopp AH, Abebe T. Cervicovaginal Microbiota Profiles in Precancerous Lesions and Cervical Cancer among Ethiopian Women. Microorganisms 2023; 11:microorganisms11040833. [PMID: 37110255 PMCID: PMC10144031 DOI: 10.3390/microorganisms11040833] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Although high-risk human papillomavirus infection is a well-established risk factor for cervical cancer, other co-factors within the local microenvironment may play an important role in the development of cervical cancer. The current study aimed to characterize the cervicovaginal microbiota in women with premalignant dysplasia or invasive cervical cancer compared with that of healthy women. The study comprised 120 Ethiopian women (60 cervical cancer patients who had not received any treatment, 25 patients with premalignant dysplasia, and 35 healthy women). Cervicovaginal specimens were collected using either an Isohelix DNA buccal swab or an Evalyn brush, and ribosomal RNA sequencing was used to characterize the cervicovaginal microbiota. Shannon and Simpson diversity indices were used to evaluate alpha diversity. Beta diversity was examined using principal coordinate analysis of weighted UniFrac distances. Alpha diversity was significantly higher in patients with cervical cancer than in patients with dysplasia and in healthy women (p < 0.01). Beta diversity was also significantly different in cervical cancer patients compared with the other groups (weighted UniFrac Bray-Curtis, p < 0.01). Microbiota composition differed between the dysplasia and cervical cancer groups. Lactobacillus iners was particularly enriched in patients with cancer, and a high relative abundance of Lactobacillus species was identified in the dysplasia and healthy groups, whereas Porphyromonas, Prevotella, Bacteroides, and Anaerococcus species predominated in the cervical cancer group. In summary, we identified differences in cervicovaginal microbiota diversity, composition, and relative abundance between women with cervical cancer, women with dysplasia, and healthy women. Additional studies need to be carried out in Ethiopia and other regions to control for variation in sample collection.
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Affiliation(s)
- Brhanu Teka
- Department of Microbiology, Immunology and Parasitology School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
- Correspondence: ; Tel.: +251-913500065
| | - Kyoko Yoshida-Court
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ededia Firdawoke
- Department of Microbiology, Immunology and Parasitology School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
| | - Zewditu Chanyalew
- Department of Pathology, St. Paul Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia
| | - Muluken Gizaw
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 34, Ethiopia
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, 06120 Halle, Germany
- NCD Working Group, Addis Ababa University, Addis Ababa P.O. Box 34, Ethiopia
| | - Adamu Addissie
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 34, Ethiopia
| | - Adane Mihret
- Department of Microbiology, Immunology and Parasitology School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia
| | - Lauren E. Colbert
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Tatiana Cisneros Napravnik
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Molly B. El Alam
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Erica J. Lynn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Melissa Mezzari
- Molecular Virology and Microbiology, Baylor College of Medicine Alkek, Center for Molecular Discovery, Houston, TX 77030, USA
| | - Jhingran Anuja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Eva Johanna Kantelhardt
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, 06120 Halle, Germany
| | - Andreas M. Kaufmann
- Department of Gynecology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Ann H. Klopp
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
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Di Salvo I, Mnzava D, Nicoletti GJ, Senkoro E, Ndege RC, Huang DJ, Makunja NT, Kassiga GI, Kaufmann AM, Weisser M, Kind AB. Upscaling cervical cancer screening and treatment for women living with HIV at a rural referral hospital in Tanzania: protocol of a before-and-after study exploring HPV testing and novel diagnostics. BMC Health Serv Res 2023; 23:234. [PMID: 36894985 PMCID: PMC9998252 DOI: 10.1186/s12913-023-09113-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 01/26/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Cervical cancer (CC) is nearly always caused by persistent human papillomavirus (HPV) infection. It is the most common cancer among women living with HIV (WLWH) and is the leading cause of cancer-related death in women in East Africa, with 10,241 new cases reported in Tanzania in 2020. In 2019, the World Health Organization (WHO) presented a global strategy for the elimination of CC as a public health problem, proposing targets to meet by 2030 for HPV vaccine coverage (90% of all 15-year-old girls), CC screening (70% of all women once at 35 and again at 45 years of age) and treatment delivery, to be scaled at national and subnational levels with a context-sensitive approach. This study aims to evaluate the upscaling of screening and treatment services at a rural referral hospital in Tanzania in order to address the second and third WHO targets. METHODS This is an implementation study with a before-and-after design performed at St. Francis Referral Hospital (SFRH) in Ifakara (south-central Tanzania). CC screening and treatment services are integrated within the local HIV Care and Treatment Center (CTC). The standard of care, consisting of visualization of the cervix with acetic acid (VIA) and cryotherapy has been up-scaled with self-sampled HPV testing and also involved the introduction of mobile colposcopy, thermal ablation and loop electrosurgical excision procedure (LEEP). Participants are WLWH aged 18 to 65 years. Outcome measures included the percentage of women screened, HPV prevalence and genotype, and adherence to screening, treatment and follow-up plan. Additionally, we will explore the performance of novel diagnostic tests (QG-MPH®, Prevo-Check® and PT Monitor®), which share the features of being manageable and inexpensive, and thus a potential tool for effective triage in HPV high-prevalence cohorts. DISCUSSION The study will provide relevant information about HPV prevalence and persistence, as well as reproductive and lifestyle indicators in a CC high-risk cohort of WLWH and about upscaling screening and treatment services at the level of a rural referral hospital in Tanzania. Furthermore, it will provide exploratory data on novel assays. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05256862, date of registration 25/02/2022. Retrospectively registered.
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Affiliation(s)
- Ivana Di Salvo
- Colposcopy Unit, Department of Gynaecology and Gynaecologic Oncology, University Hospital of Basel, Spitalstrasse 21, Basel, 4031, Switzerland.,Chronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.,Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Dorcas Mnzava
- Chronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania
| | - Giovanni Jacopo Nicoletti
- Chronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.,Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Elizabeth Senkoro
- Chronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.,Saint Francis Referral Hospital, Ifakara, Tanzania
| | - Robert C Ndege
- Chronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.,Saint Francis Referral Hospital, Ifakara, Tanzania
| | - Dorothy J Huang
- Colposcopy Unit, Department of Gynaecology and Gynaecologic Oncology, University Hospital of Basel, Spitalstrasse 21, Basel, 4031, Switzerland
| | - Nathalia Tobias Makunja
- Saint Francis Referral Hospital, Ifakara, Tanzania.,Department of Obstetrics and Gynecology, St. Francis Referral District Hospital, Ifakara, Tanzania
| | - George I Kassiga
- Saint Francis Referral Hospital, Ifakara, Tanzania.,Department of Obstetrics and Gynecology, St. Francis Referral District Hospital, Ifakara, Tanzania
| | - Andreas M Kaufmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynaecology, HPV Laboratory, Berlin, Germany
| | - Maja Weisser
- Chronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.,University of Basel, Basel, Switzerland.,Department of Infectious Diseases & Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
| | - André B Kind
- Colposcopy Unit, Department of Gynaecology and Gynaecologic Oncology, University Hospital of Basel, Spitalstrasse 21, Basel, 4031, Switzerland. .,University of Basel, Basel, Switzerland.
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7
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Liang L, Kaufmann AM. The Significance of Cancer Stem Cells and Epithelial-Mesenchymal Transition in Metastasis and Anti-Cancer Therapy. Int J Mol Sci 2023; 24:ijms24032555. [PMID: 36768876 PMCID: PMC9917228 DOI: 10.3390/ijms24032555] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
Cancer stem cells (CSCs) have been identified and characterized in both hematopoietic and solid tumors. Their existence was first predicted by Virchow and Cohnheim in the 1870s. Later, many studies showed that CSCs can be identified and isolated by their expression of specific cell markers. The significance of CSCs with respect to tumor biology and anti-cancer treatment lies in their ability to maintain quiescence with very slow proliferation, indefinite self-renewal, differentiation, and trans-differentiation such as epithelial-mesenchymal transition (EMT) and its reverse process mesenchymal-epithelial transition (MET). The ability for detachment, migration, extra- and intravasation, invasion and thereby of completing all necessary steps of the metastatic cascade highlights their significance for metastasis. CSCs comprise the cancer cell populations responsible for tumor growth, resistance to therapies and cancer metastasis. In this review, the history of the CSC theory, their identification and characterization and their biology are described. The contribution of the CSC ability to undergo EMT for cancer metastasis is discussed. Recently, novel strategies for drug development have focused on the elimination of the CSCs specifically. The unique functional and molecular properties of CSCs are discussed as possible therapeutic vulnerabilities for the development of novel anti-metastasis treatments. Prospectively, this may provide precise personalized anti-cancer treatments with improved therapeutic efficiency with fewer side effects and leading to better prognosis.
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8
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Metz CK, Skof AS, Sehouli J, Siedentopf JP, Gebert P, Weiss F, Alba Alejandre I, Heinrich-Rohr M, Weizsaecker K, Henrich W, Kaufmann AM, Rohr I. Assessment of high-risk human papillomavirus infections and associated cervical dysplasia in HIV-positive pregnant women in Germany: a prospective cross-sectional two-centre study. Arch Gynecol Obstet 2022; 308:207-218. [PMID: 36576558 DOI: 10.1007/s00404-022-06890-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE Invasive cervical cancer (ICC) is associated in nearly 100% with persistent high-risk Human Papillomavirus (HR-HPV) infection. ICC is still one of the leading causes for cancer mortality in women worldwide. The immunosuppressive influence of Human Immunodeficiency Virus (HIV) and the immunocompromised period of pregnancy due to tolerance induction against the hemiallogeneic fetus, are generally risk factors for acquisition and persistence of HR-HPV infections and their progression to precancerous lesions and HPV-associated carcinoma. METHODS Overall, 81 pregnant women living with HIV (WLWH) were included. A medical history questionnaire was used to record clinical and HIV data. Participants received cervicovaginal cytological smear, colposcopy and HPV testing. HPV test was performed using BSGP5+/6+ PCR with Luminex read-out. The HR-HPV genotypes 16, 18, 31, 33, 45, 52, 58 were additionally grouped together as high-high-risk HPV (HHR-HPV) for the purpose of risk-adapted analysis. RESULTS HR-HPV prevalence was 45.7%. Multiple HPV infections were detected in 27.2% of participants, of whom all had at least one HR-HPV genotype included. HR-HPV16 and HR-HPV52 were the most prevalent genotypes and found when high squamous intraepithelial lesion (HSIL) was detected by cytology. HIV viral load of ≥ 50 copies/ml was associated with higher prevalence of HR-HPV infections. Whereas, CD4 T cells < 350/µl showed association with occurrence of multiple HPV infections. Time since HIV diagnosis seemed to impact HPV prevalence. CONCLUSION Pregnant WLWH require particularly attentive and extended HPV-, colposcopical- and cytological screening, whereby clinical and HIV-related risk factors should be taken into account.
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Affiliation(s)
- Charlotte K Metz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Obstetrics, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Anna S Skof
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department for Gynecology, Laboratory for Gynaecological Tumor Immunology, HPV Laboratory, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jalid Sehouli
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department for Gynecology, Laboratory for Gynaecological Tumor Immunology, HPV Laboratory, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jan-Peter Siedentopf
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Obstetrics, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Pimrapat Gebert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117, Berlin, Germany
| | - Fabian Weiss
- Ludwig-Maximilians-University (LMU), University Hospital, Department of Obstetrics and Gynecology, Marchioninistrasse 15, 81377, Munich, Germany
| | - Irene Alba Alejandre
- Ludwig-Maximilians-University (LMU), University Hospital, Department of Obstetrics and Gynecology, Marchioninistrasse 15, 81377, Munich, Germany
| | - Michaela Heinrich-Rohr
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute for Social Medicine, Epidemiology and Health Economic, Luisenstraße 57, 10117, Berlin, Germany
| | - Katharina Weizsaecker
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Obstetrics, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Wolfgang Henrich
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Obstetrics, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Andreas M Kaufmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department for Gynecology, Laboratory for Gynaecological Tumor Immunology, HPV Laboratory, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Irena Rohr
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Obstetrics, Augustenburger Platz 1, 13353, Berlin, Germany.
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Xu Q, Chen Y, Jin Y, Wang Z, Dong H, Kaufmann AM, Albers AE, Qian X. Advanced Nanomedicine for High-Risk HPV-Driven Head and Neck Cancer. Viruses 2022; 14:v14122824. [PMID: 36560828 PMCID: PMC9788019 DOI: 10.3390/v14122824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
The incidence of high-risk Human Papillomavirus (HR-HPV)-driven head and neck squamous cell carcinoma (HNSCC) is on the rise globally. HR-HPV-driven HNSCC displays molecular and clinical characteristics distinct from HPV-uninvolved cases. Therapeutic strategies for HR-HPV-driven HNSCC are under investigation. HR-HPVs encode the oncogenes E6 and E7, which are essential in tumorigenesis. Meanwhile, involvement of E6 and E7 provides attractive targets for developing new therapeutic regimen. Here we will review some of the recent advancements observed in preclinical studies and clinical trials on HR-HPV-driven HNSCC, focusing on nanotechnology related methods. Materials science innovation leads to great improvement for cancer therapeutics including HNSCC. This article discusses HPV-E6 or -E7- based vaccines, based on plasmid, messenger RNA or peptide, at their current stage of development and testing as well as how nanoparticles can be designed to target and access cancer cells and activate certain immunology pathways besides serving as a delivery vehicle. Nanotechnology was also used for chemotherapy and photothermal treatment. Short interference RNA targeting E6/E7 showed some potential in animal models. Gene editing by CRISPR-CAS9 combined with other treatments has also been assessed. These advancements have the potential to improve the outcome in HR-HPV-driven HNSCC, however breakthroughs are still to be awaited with nanomedicine playing an important role.
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Affiliation(s)
- Qiang Xu
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou 310022, China
| | - Ye Chen
- Department of Clinical Laboratory, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, No. 1 East Banshan Road, Gongshu District, Hangzhou 310022, China
| | - Yuan Jin
- Department of Clinical Laboratory, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, No. 1 East Banshan Road, Gongshu District, Hangzhou 310022, China
| | - Zhiyu Wang
- Department of Clinical Laboratory, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, No. 1 East Banshan Road, Gongshu District, Hangzhou 310022, China
- Wenzhou Medical University, Wenzhou 325000, China
| | - Haoru Dong
- Department of Clinical Laboratory, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, No. 1 East Banshan Road, Gongshu District, Hangzhou 310022, China
- Wenzhou Medical University, Wenzhou 325000, China
| | - Andreas M. Kaufmann
- Clinic for Gynecology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, 12203 Berlin, Germany
| | - Andreas E. Albers
- Department of Clinical Medicine, Oto-Rhino-Laryngology, Medical School Berlin, 14197 Berlin, Germany
| | - Xu Qian
- Department of Clinical Laboratory, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, No. 1 East Banshan Road, Gongshu District, Hangzhou 310022, China
- Correspondence:
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10
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Teka B, Gizaw M, Firdawoke E, Addissie A, Sisay TA, Schreckenberger C, Skof AS, Thies S, Mihret A, Kantelhardt EJ, Abebe T, Kaufmann AM. A Technical Comparison of Human Papillomavirus Genotyping Assays from a Population-Based Cervical Cancer Screening in South Central Ethiopia. Cancer Manag Res 2022; 14:2253-2263. [PMID: 35937937 PMCID: PMC9346300 DOI: 10.2147/cmar.s360712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose High-risk Human Papillomavirus (HPV) is the most important cause of cervical cancer. The highest burden of disease is seen in Low- and Low-Middle-Income Countries (LMIC). Several new HPV screening assays have been developed for high-risk HPV (hr-HPV) testing. We compared the performance and adequacy of three HPV genotyping assays on samples from a population of rural women in south-central Ethiopia. Patients and Methods One hundred and ten cervical swabs from rural women screened for HPV were assayed. HPV DNA was tested using MPG-Luminex Assay, Anyplex II HPV HR Detection, and EUROArray HPV. MPG-Luminex Assay was used as a reference method to compute the sensitivity and specificity of the two commercial assays in detecting hr-HPV infections. Results Of the 110 samples, MPG-Luminex Assay found 18.2% positive for the 14 hr-HPV and 7.3% for the probable hr-HPV genotypes. Anyplex™ II HPV HR Detection assay and EUROArray HPV Assay identified 21.82% and 12.7% samples, respectively, for the 14 hr-HPVs and both 7.3% for the probable hr-HPV genotypes (κ=0.734). Among the 14 hr-HPV genotypes, the genotype-specific agreement of the three HPV genotyping assays was moderate or better for HPV16, 31, 35, 39, 52, 56, 66 and 68. The aggregated sensitivity in detecting the 14 hr-HPV infections of Anyplex™ II HPV HR Detection and EUROArray HPV assays was high, 100% and 70%, respectively. The specificities of Anyplex™ II HPV HR Detection and EUROArray HPV were 95.6% and 100%, respectively. Conclusion The three evaluated assays showed similar analytical performance in the detection of hr-HPV infections and moderate or better concordance in HPV genotyping. This study is part of the ongoing cluster-randomized trial that has been registered in clinicaltrials.gov (NCT03281135) on September 13, 2017.
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Affiliation(s)
- Brhanu Teka
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Gynaecology Martin-Luther-University, Halle-Wittenberg, Germany
| | - Muluken Gizaw
- Department of Gynaecology Martin-Luther-University, Halle-Wittenberg, Germany
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Ededia Firdawoke
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adamu Addissie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tesfamichael Awoke Sisay
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Carola Schreckenberger
- Department of Gynecology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
| | - Anna Sophie Skof
- Department of Gynecology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
| | - Sarah Thies
- Department of Gynecology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
| | - Adane Mihret
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Eva Johanna Kantelhardt
- Department of Gynaecology Martin-Luther-University, Halle-Wittenberg, Germany
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andreas M Kaufmann
- Department of Gynecology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
- Correspondence: Andreas M Kaufmann, Tel +49 30 450516499, Fax +4930 450-7 564958, Email
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Guo F, Yang Z, Sehouli J, Kaufmann AM. Blockade of ALDH in Cisplatin-Resistant Ovarian Cancer Stem Cells In Vitro Synergistically Enhances Chemotherapy-Induced Cell Death. Curr Oncol 2022; 29:2808-2822. [PMID: 35448203 PMCID: PMC9031660 DOI: 10.3390/curroncol29040229] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022] Open
Abstract
Epithelial ovarian cancer (EOC) is the leading cause of gynecological cancer-related death. The high mortality and morbidity associated with EOC are mostly due to late diagnosis and chemotherapy drug resistance. Currently, the standard first-line chemotherapy regimen is systemic administration of platinum-based chemotherapy combined with a taxane. A major problem besides cisplatin resistance (occurring in nearly one-third of patients) is the greater toxicity of the drug combinations. A synergistic treatment with drug supporting activity could maximize the cytotoxic effects of chemotherapeutic agents on tumor cells while decreasing the dosage of each drug to potentially reduce toxicity. The ALDH-blocking agent Disulfiram (DSF), a clinically approved drug used for alcoholism treatment, has displayed promising anti-cancer activity. We previously described that blocking ALDH activity enhances the induction of apoptosis, especially in ovarian cancer stem cells treated with chemotherapeutic agents. In this study, we further investigated the synergistic effect of DSF in combination with cytotoxic chemotherapeutic drugs. The concentration of each chemotherapeutic agent could be significantly reduced with sustained efficacy on tumor cell apoptosis in cell lines in vitro (Dose-Reduction Index at IC50 from 1 to 50). Moreover, the potential chemo-sensitizing effects of DSF on ALDH-associated cisplatin-resistant ovarian cancer stem cells were also investigated and shown that in contrast to its high resistance to cisplatin, the cisplatin-resistant cells remain very sensitive to DSF-induced cytotoxicity (apoptosis and necrosis: cisplatin-resistant cells vs. parental cells: 60.4% vs. 20.5%). In combination with DSF and cisplatin, relatively more apoptosis and necrosis were induced in cisplatin-resistant cells than in their parental cells (apoptosis and necrosis: cisplatin-resistant cells vs. parental cells: 81.5% vs. 50.1%). A transcriptome analysis identified that ALDH was mainly enriched in the cancer-associated fibroblasts and showed that ALDH plays roles in responding to oxidative stress, metabolisms, and energy transition in the ALDH-associated cisplatin-resistant ovarian cancer stem cells. In conclusion, our data demonstrate a key role of ALDH-associated cisplatin-resistant cancer stem cells and identifies DSF as a potential adjuvant for a rational protocol design by computational quantitative assessment in vitro on ovarian cancer cell lines. Our work contributes to resolving the ALDH-associated cisplatin resistance and provides a resource for the development of novel chemotherapeutic regimens.
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Affiliation(s)
- Fang Guo
- Department of Gynecology, Shenzhen Hospital of Southern Medical University, Shenzhen 518100, China;
| | - Zhi Yang
- Department of Orthopedics, Shenzhen Hospital of Southern Medical University, Shenzhen 518100, China;
| | - Jalid Sehouli
- Department of Gynecology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany;
| | - Andreas M. Kaufmann
- Department of Gynecology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany;
- HPV Research Laboratory, Department of Gynecology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Correspondence: ; Tel.: +49-(0)30-450-516-499; Fax: +49-(0)30-450-7-564-958
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Wagner A, Skof AS, Sehouli J, Richter R, Henrich W, von Weizsäcker K, Siedentopf JP, Chekerov R, Kaufmann AM, Rohr I. Genotype-specific high-risk human papillomavirus infections and risk factors for cervical dysplasia in women with human immunodeficiency virus in Germany: results from a single-center cross-sectional study. Int J Gynecol Cancer 2022; 32:716-723. [PMID: 35354606 DOI: 10.1136/ijgc-2021-003327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Women living with HIV have an increased risk of human papillomavirus (HPV) infection and cervical cancer. Little is known about genotype-specific HPV prevalence, the impact of antiretroviral therapy, immunological status, and additional risk factors in women living with HIV in Germany. The goal of this study was to characterize the risk profile for cervical dysplasia in these women. METHODS Patients with HIV infection presenting at Charité-Universitätsmedizin Berlin from October 2017 to September 2020 were included and underwent gynecological examination, colposcopy, cervical cytology and HPV genotype testing. HPV genotypes were stratified by carcinogenicity. Atypical squamous cells of undetermined significance or higher were considered abnormal cytology. Data were analyzed by SPSS software (version 26, 2019). A two-tailed p-value ≤0.05 was considered statistically significant. RESULTS A total of 84 women were evaluated. The majority (95.2%) received antiretroviral therapy. Median CD4 cell count was 564 cells/µl (range 20-1969). 95.2% were previously screened for cervical cancer. High-risk HPV prevalence was 44%. High-high-risk HPV subtypes (16, 18, 31, 33, 45, 52, 58) were significantly associated with abnormal cytology (p<0.001). HPV16 was the most common genotype (23%), was significantly associated with abnormal cytology (p=0.002) and was the main risk factor for abnormal cytology (OR 8.55, 95% CI 2.15 to 34.13, p=0.002), followed by age <35 years (OR 4.96, 95% CI 1.23 to 19.61, p=0.033) and cigarette smoking (OR 3.944, 95% CI 0.98 to 15.88, p=0.053). CONCLUSIONS Antiretroviral therapy and adherence to cervical cancer screening was high. High-high-risk HPV, especially HPV16, coincided with high incidence of cytological abnormalities. Women living with HIV in Germany have adequate immune status and are often pre-screened for cervical cancer, and therefore have a different risk profile for cervical dysplasia than in low-income or medium-income countries. Adapted screening programs should be defined.
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Affiliation(s)
- Alexandra Wagner
- Department of Gynecology with Center for Oncological Surgery, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
- Department of Obstetrics, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Anna Sophie Skof
- Department of Gynecology with Center for Oncological Surgery, Laboratory for Gynecological Tumor Immunology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Rolf Richter
- Department of Gynecology with Center for Oncological Surgery, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Wolfgang Henrich
- Department of Obstetrics, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Katharina von Weizsäcker
- Department of Obstetrics, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Jan-Peter Siedentopf
- Department of Obstetrics, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Radoslav Chekerov
- Department of Gynecology with Center for Oncological Surgery, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Andreas M Kaufmann
- Department of Gynecology with Center for Oncological Surgery, Laboratory for Gynecological Tumor Immunology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Irena Rohr
- Department of Gynecology with Center for Oncological Surgery, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
- Department of Obstetrics, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
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Dong H, Shu X, Xu Q, Zhu C, Kaufmann AM, Zheng ZM, Albers AE, Qian X. Current Status of Human Papillomavirus-Related Head and Neck Cancer: From Viral Genome to Patient Care. Virol Sin 2021. [PMID: 34152564 DOI: 10.1007/s12250-021-00413-8/figures/2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Human papillomavirus (HPV) infection identified as a definitive human carcinogen is increasingly being recognized for its role in carcinogenesis of human cancers. Up to 38%-80% of head and neck squamous cell carcinoma (HNSCC) in oropharyngeal location (OPSCC) and nearly all cervical cancers contain the HPV genome which is implicated in causing cancer through its oncoproteins E6 and E7. Given by the biologically distinct HPV-related OPSCC and a more favorable prognosis compared to HPV-negative tumors, clinical trials on de-escalation treatment strategies for these patients have been studied. It is therefore raised the questions for the patient stratification if treatment de-escalation is feasible. Moreover, understanding the crosstalk of HPV-mediated malignancy and immunity with clinical insights from the proportional response rate to immune checkpoint blockade treatments in patients with HNSCC is of importance to substantially improve the treatment efficacy. This review discusses the biology of HPV-related HNSCC as well as successful clinically findings with promising candidates in the pipeline for future directions. With the advent of various sequencing technologies, further biomolecules associated with HPV-related HNSCC progression are currently being identified to be used as potential biomarkers or targets for clinical decisions throughout the continuum of cancer care.
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Affiliation(s)
- Haoru Dong
- Department of Clinical Laboratory, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Xinhua Shu
- Department of Clinical Laboratory, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Qiang Xu
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Chen Zhu
- Department of Cancer Prevention, Cancer Hospital University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Andreas M Kaufmann
- Clinic for Gynecology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, 12203, Germany
| | - Zhi-Ming Zheng
- Tumor Virus RNA Biology Section, HIV Dynamics and Replication Program, National Cancer Institute, National Institutes of Health, Frederick, MD, 21702, USA
| | - Andreas E Albers
- Department of Otolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, 13353, Germany
| | - Xu Qian
- Department of Clinical Laboratory, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China.
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Dong H, Shu X, Xu Q, Zhu C, Kaufmann AM, Zheng ZM, Albers AE, Qian X. Current Status of Human Papillomavirus-Related Head and Neck Cancer: From Viral Genome to Patient Care. Virol Sin 2021; 36:1284-1302. [PMID: 34152564 PMCID: PMC8692589 DOI: 10.1007/s12250-021-00413-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/18/2021] [Indexed: 12/24/2022] Open
Abstract
Human papillomavirus (HPV) infection identified as a definitive human carcinogen is increasingly being recognized for its role in carcinogenesis of human cancers. Up to 38%–80% of head and neck squamous cell carcinoma (HNSCC) in oropharyngeal location (OPSCC) and nearly all cervical cancers contain the HPV genome which is implicated in causing cancer through its oncoproteins E6 and E7. Given by the biologically distinct HPV-related OPSCC and a more favorable prognosis compared to HPV-negative tumors, clinical trials on de-escalation treatment strategies for these patients have been studied. It is therefore raised the questions for the patient stratification if treatment de-escalation is feasible. Moreover, understanding the crosstalk of HPV-mediated malignancy and immunity with clinical insights from the proportional response rate to immune checkpoint blockade treatments in patients with HNSCC is of importance to substantially improve the treatment efficacy. This review discusses the biology of HPV-related HNSCC as well as successful clinically findings with promising candidates in the pipeline for future directions. With the advent of various sequencing technologies, further biomolecules associated with HPV-related HNSCC progression are currently being identified to be used as potential biomarkers or targets for clinical decisions throughout the continuum of cancer care.
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Affiliation(s)
- Haoru Dong
- Department of Clinical Laboratory, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Xinhua Shu
- Department of Clinical Laboratory, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Qiang Xu
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Chen Zhu
- Department of Cancer Prevention, Cancer Hospital University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Andreas M Kaufmann
- Clinic for Gynecology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, 12203, Germany
| | - Zhi-Ming Zheng
- Tumor Virus RNA Biology Section, HIV Dynamics and Replication Program, National Cancer Institute, National Institutes of Health, Frederick, MD, 21702, USA
| | - Andreas E Albers
- Department of Otolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, 13353, Germany
| | - Xu Qian
- Department of Clinical Laboratory, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China.
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Cherif S, Amine A, Thies S, Taube ET, Braicu EI, Sehouli J, Kaufmann AM. Prevalence of human papillomavirus detection in ovarian cancer: a meta-analysis. Eur J Clin Microbiol Infect Dis 2021; 40:1791-1802. [PMID: 34086102 PMCID: PMC8346400 DOI: 10.1007/s10096-021-04282-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/26/2021] [Indexed: 12/13/2022]
Abstract
We conducted a meta-analysis of published data to update and estimate the prevalence of HPV in ovarian cancer. A comprehensive literature search was performed according to the PRISMA guidelines. Eligible articles published from 1989 until 2020 by searching Web of Sciences, Pubmed, Embase, and the Cochrane Library Central databases were gathered. A pooled estimation of HPV prevalence with a 95% confidence interval (CI) was calculated based on a random effect model. Quantitative assessment of heterogeneity was explored using Cochrane test and I2. Additionally, publication bias, sensitivity, meta-regression, and subgroup analyses were also performed. Twenty-nine studies involving 2280 patients with ovarian cancer were included. The statistical heterogeneity was high (I2 = 88%, P<0.0001). The pooled prevalence of HPV in ovarian cancer cases was 15.9% (95% CI, 11–22). In subgroup analyses, the highest prevalence of HPV was reported by studies from Asia (30.9%; 95% CI, 20–44) and Eastern Europe (29.3%; 95% CI, 4.4–78). Furthermore, the most frequently detected HPV genotype was HPV16 (54%; 95% CI, 27.9–55), followed by HPV18 (23.2%; 95% CI, 18.8–28.2). Our meta-analysis suggests a great difference in the prevalence of HPV detected in ovarian cancer by different studies, which is not seen in strongly HPV-associated cancers such as cervical cancer. However, the prevalence varied markedly by geographic region. Considering the substantial heterogeneity found, more studies with control groups and precise assays measuring HPV mRNA expression are needed to further evaluate the link and causative aetiology between HPV and ovarian cancer.
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Affiliation(s)
- Soumia Cherif
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany.,Laboratory of Biochemistry, Environment, and Agrifood, Faculty of Sciences and Techniques-Mohammedia, Hassan II University, 8 Casablanca, Morocco
| | - Abdessamad Amine
- Laboratory of Biochemistry, Environment, and Agrifood, Faculty of Sciences and Techniques-Mohammedia, Hassan II University, 8 Casablanca, Morocco
| | - Sarah Thies
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Eliane T Taube
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute for Pathology, Charitéplatz 1, 10117, Berlin, Germany
| | - Elena Ioana Braicu
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jalid Sehouli
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Andreas M Kaufmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany.
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16
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Behnke AL, Krings A, Wormenor CM, Dunyo P, Kaufmann AM, Amuah JE. Female health-care providers' advocacy of self-sampling after participating in a workplace program for cervical cancer screening in Ghana: a mixed-methods study. Glob Health Action 2021; 13:1838240. [PMID: 33200671 PMCID: PMC7671662 DOI: 10.1080/16549716.2020.1838240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cervical cancer is the second most common cancer among Ghanaian women and screening coverage is low. ACCESSING is a cross-sectional study investigating human papillomavirus (HPV) prevalence via self-sampling in rural communities of the North Tongu district in Ghana. Female health-care providers (HCPs) were invited to self-collect a cervicovaginal sample with a commercial sampler in order to acquaint themselves with the sampling method. OBJECTIVE This study set out to explore female HCPs' perceptions, advocacy for, and implications of self-sampling with the aim of enhancing self-sampling acceptability in the targeted screening population. METHODS A mixed-methods approach was used, consisting of (a) a survey among 52 female HCPs working in a district hospital and (b) 10 one-to-one semi-structured interviews with purposefully sampled HCPs. RESULTS The quantitative analysis of the survey (n = 52) showed that, among HCPs who took the sample themselves (50/52), all found it 'Easy' or 'Very Easy' and felt 'Very Comfortable' or 'Comfortable'. 82.7% indicated that they would undertake screening more often, and 98.1% indicated they would prefer self-sampling, if cervical cancer risk is as reliably determined as by clinician-directed cytobrush sampling. All interview participants (n = 10) indicated that they appreciated the program and would recommend the screening to their patients and/or family members and neighbours. Common reasons for preferring self-sampling were less (anticipated) pain compared to speculum examination and more privacy. CONCLUSIONS Self-sampling for cervical cancer screening is highly acceptable to female HCPs. Setting up a workplace screening program that entails the option of self-sampling could create greater awareness and positive attitudes among HCPs to educating their patients, families, and neighbours on cervical cancer risks and motivate HCPs to advocate for women's participation in screening.
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Affiliation(s)
- Anna-Lisa Behnke
- Clinic for Gynaecology (CBF), Laboratory for Gynaecologic Tumor Immunology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin , Berlin, Germany
| | - Amrei Krings
- Clinic for Gynaecology (CBF), Laboratory for Gynaecologic Tumor Immunology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin , Berlin, Germany
| | | | - Priscilla Dunyo
- Department of Obstetrics and Gynecology, Catholic Hospital Battor , Battor, Ghana
| | - Andreas M Kaufmann
- Clinic for Gynaecology (CBF), Laboratory for Gynaecologic Tumor Immunology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin , Berlin, Germany
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17
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Younes S, Kaufmann AM, Häfner N, Beer K, Jansen L, Sanft J, Mall G, Koops S, Dürst M, Schneider A. Evidence for disseminated tumor cells in lymphatic vessels afferent to sentinel lymph nodes in patients diagnosed with cervical cancer. Cancer Rep (Hoboken) 2021; 4:e1366. [PMID: 33719186 PMCID: PMC8388156 DOI: 10.1002/cnr2.1366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In patients diagnosed with cervical cancer, the purpose of lymphadenectomy is the removal of lymph nodes for diagnosis and potential treatment of metastasized tumor cells. It is unclear if afferent lymphatic vessels harbor tumor cells and, thus, may pose additional risk for recurrence or progression if not removed. AIM In this feasibility study, we analyzed the lymphatic vessels afferent to sentinel lymph node (SLN) using a highly sensitive and specific molecular marker for cervical cancer cells. METHODS AND RESULTS Twenty patients diagnosed with cervical cancer of FIGO stage IA1 to IIB2 underwent laparoscopic SLN removal. Labeling was done using patent blue and the afferent lymphatic vessels were harvested from the parametric tissue and frozen at -80°C. HPV DNA type was evaluated in the primary tumor. Lymphatic vessels afferent to the sentinel lymph nodes were analyzed for the presence of viral oncogene transcripts of the respective HPV type. In one of 18 patients, all with tumor stage ≤IBI and pN0 by conventional histopathology, HPV mRNA could be detected in two of four lymphatic vessels, whereas at least one of the lymphatic vessel biopsies of both patients with tumors ˃4 cm and pN1 status was HPV mRNA positive. No clinical correlation with recurrence after a median follow-up of 9 years was noticed. CONCLUSION HPV mRNA indicative of disseminated tumor cells could be detected in lymphatic vessels. The relevance of harvesting lymphatic vessels afferent to SLN in order to increase oncologic safety will have to be investigated in a future prospective study.
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Affiliation(s)
- Shadi Younes
- Department of Gynaecology, Klinikum Bremen-Nord, Bremen, Germany
| | - Andreas M Kaufmann
- Department of Gynaecology, Charité Medical University Berlin, Berlin, Germany
| | - Norman Häfner
- Department of Gynaecology, Jena University Hospital, Jena, Germany
| | - Katrin Beer
- Department of Gynaecology, Jena University Hospital, Jena, Germany
| | - Lars Jansen
- Department of Gynaecology, Jena University Hospital, Jena, Germany
| | - Juliane Sanft
- Institute for Forensic Medicine, Jena University Hospital, Jena, Germany
| | - Gita Mall
- Institute for Forensic Medicine, Jena University Hospital, Jena, Germany
| | - Susan Koops
- Institute for Cytology and Dysplasia, MVZ im Fürstenberg-Karree, Berlin, Germany
| | - Matthias Dürst
- Department of Gynaecology, Jena University Hospital, Jena, Germany
| | - Achim Schneider
- Institute for Cytology and Dysplasia, MVZ im Fürstenberg-Karree, Berlin, Germany
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18
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Gross GE, Werner RN, Avila Valle GL, Bickel M, Brockmeyer NH, Doubek K, Gallwas J, Gieseking F, Haase H, Hillemanns P, Ikenberg H, Jongen J, Kaufmann AM, Klußmann JP, von Knebel Doeberitz M, Knuf M, Köllges R, Laws HJ, Mikolajczyk R, Neis KJ, Petry KU, Pfister H, Schlaeger M, Schneede P, Schneider A, Smola S, Tiews S, Nast A, Gaskins M, Wieland U. Evidenz‐ und konsensbasierte (S3) Leitlinie: Impfprävention HPV‐assoziierter Neoplasien. J Dtsch Dermatol Ges 2021; 19:479-494. [PMID: 33709591 DOI: 10.1111/ddg.14438_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Gerd E Gross
- Klinik für Dermatologie und Venerologie, Universitätsklinik Rostock, Rostock.,Paul-Ehrlich-Gesellschaft für Chemotherapie e.V., HPV Management Forum
| | - Ricardo N Werner
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, -corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin -Institute of Health, Berlin
| | - Gabriela L Avila Valle
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, -corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin -Institute of Health, Berlin
| | | | - Norbert H Brockmeyer
- Klinik für Dermatologie, Venerologie und Allergologie der Ruhr-Universität -Bochum, Zentrum für Sexuelle Gesundheit - WIR "Walk In Ruhr", Bochum
| | | | - Julia Gallwas
- Klinik für Gynäkologie und Geburtshilfe, Georg-August-Universität Göttingen
| | | | | | | | - Hans Ikenberg
- MVZ für Zytologie und Molekularbiologie Frankfurt GbR (CytoMol), Frankfurt am Main
| | | | - Andreas M Kaufmann
- Klinik für Gynäkologie, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - Jens Peter Klußmann
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Uniklinik Köln, Medizinische Fakultät, Universität zu Köln
| | - Magnus von Knebel Doeberitz
- Abteilung für Angewandte Tumorbiologie, Institut für Pathologie, Universitätsklinikum Heidelberg und Klinische Kooperationseinheit G105 des Deutschen Krebsforschungszentrums (DKFZ)
| | - Markus Knuf
- Klinik für Kinder und Jugendliche, Helios Dr. Horst Schmidt Kliniken, Wiesbaden.,Pädiatrische Infektiologie, Universitätsmedizin Mainz, Mainz
| | - Ralf Köllges
- Praxis für Kinder und Jugendliche, Mönchengladbach
| | - Hans-Jürgen Laws
- Klinik für Kinderonkologie, -hämatologie und Klinische Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf
| | - Rafael Mikolajczyk
- Institut für Medizinische Epidemiologie, Biometrie und Informatik (IMEBI), Martin-Luther Universität Halle-Wittenberg, Halle (Saale)
| | | | | | | | | | | | | | - Sigrun Smola
- Institut für Virologie, Universitätsklinikum des Saarlandes, Medizinische Fakultät, Universität des Saarlandes, Homburg/Saar
| | - Sven Tiews
- MVZ Labor für Cytopathologie Dr. Steinberg GmbH, Soest
| | - Alexander Nast
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, -corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin -Institute of Health, Berlin
| | - Matthew Gaskins
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, -corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin -Institute of Health, Berlin
| | - Ulrike Wieland
- Nationales Referenzzentrum für Papillom- und Polyomaviren, Institut für Virologie, Uniklinik Köln, Universität zu Köln, Köln
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19
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Gross GE, Werner RN, Avila Valle GL, Bickel M, Brockmeyer NH, Doubek K, Gallwas J, Gieseking F, Haase H, Hillemanns P, Ikenberg H, Jongen J, Kaufmann AM, Klußmann JP, von Knebel Doeberitz M, Knuf M, Köllges R, Laws HJ, Mikolajczyk R, Neis KJ, Petry KU, Pfister H, Schlaeger M, Schneede P, Schneider A, Smola S, Tiews S, Nast A, Gaskins M, Wieland U. German evidence and consensus-based (S3) guideline: Vaccination recommendations for the prevention of HPV-associated lesions. J Dtsch Dermatol Ges 2021; 19:479-494. [PMID: 33634583 DOI: 10.1111/ddg.14438] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/10/2020] [Indexed: 11/28/2022]
Abstract
Anogenital and oropharyngeal infections with human papilloma viruses (HPV) are common. Clinically manifest disease may significantly impact quality of life; the treatment of HPV-associated lesions is associated with a high rate of recurrence and invasive neoplasms, such as cervical, anal, vulvar, penile, and oropharyngeal cancers, which are characterized by significant morbidity and mortality. Vaccination against HPV is an effective and safe measure for the primary prevention of HPV-associated lesions, but immunization rates are still low in Germany. The present publication is an abridged version of the German evidence and consensus-based guideline "Vaccination recommendations for the prevention of HPV-associated lesions", which is available on the website of the German Association of the Scientific Medical Societies (AWMF). On the basis of a systematic review with meta-analyses, a representative panel developed and agreed upon recommendations for the vaccination of different populations against HPV. In addition, consensus-based recommendations were developed for specific issues relevant to everyday practice. Based on current evidence and a representative expert consensus, these recommendations are intended to provide guidance in a field in which there is often uncertainty and in which both patients and health care providers are sometimes confronted with controversial and emotionally charged points of view.
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Affiliation(s)
- Gerd E Gross
- Department of Dermatology and Venereology, University Hospital Rostock, Rostock, Germany.,Paul Ehrlich Society for Chemotherapy, HPV Management Forum, Germany
| | - Ricardo N Werner
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gabriela L Avila Valle
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Markus Bickel
- Infektiologikum Frankfurt, Frankfurt am Main, Germany
| | - Norbert H Brockmeyer
- Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Center for Sexual Health - WIR "Walk In Ruhr", Bochum, Germany
| | - Klaus Doubek
- Gynecology Office Dr. Klaus Doubek, Wiesbaden, Germany
| | - Julia Gallwas
- Department of Gynecology and Obstetrics, Georg August University Göttingen, Göttingen, Germany
| | | | | | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Hans Ikenberg
- MVZ for Cytology and Molecular Biology (CytoMol), Frankfurt am Main, Germany
| | | | - Andreas M Kaufmann
- Department of Gynecology, Campus Virchow Hospital, Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin and Berlin Institute of Health, Berlin, Germany
| | - Jens Peter Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, -University Hospital of Cologne, Medical Faculty, University of Cologne, Cologne, Germany
| | - Magnus von Knebel Doeberitz
- Department of Applied Tumor Biology, Institute of Pathology, University Hospital Heidelberg, Clinical Cooperation Unit G105 of the German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Markus Knuf
- Hospital for Child and Adolescent Health, Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Germany.,Pediatric Infectiology, University Medical Center Mainz, Mainz, Germany
| | - Ralf Köllges
- Office for Child and Adolescent Health, Mönchengladbach, Germany
| | - Hans-Jürgen Laws
- Department of Pediatric Oncology, Hematology and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometry and Informatics (IMEBI), Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Klaus J Neis
- Gynecology Office am Staden, Saarbrücken, Germany
| | | | - Herbert Pfister
- Institute of Virology, University of Cologne, Cologne, Germany
| | | | | | | | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Medical Faculty, Saarland University, Homburg/Saar, Germany
| | - Sven Tiews
- MVZ Laboratory for Cytopathology Dr. Steinberg GmbH, Soest, Germany
| | - Alexander Nast
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Matthew Gaskins
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ulrike Wieland
- National Reference Center for Papilloma and Polyoma Viruses, Institute of Virology, University Hospital of Cologne, University of Cologne, Cologne, Germany
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20
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Teka B, Gizaw M, Ruddies F, Addissie A, Chanyalew Z, Skof AS, Thies S, Mihret A, Kantelhardt EJ, Kaufmann AM, Abebe T. Population-based human papillomavirus infection and genotype distribution among women in rural areas of South Central Ethiopia. Int J Cancer 2020; 148:723-730. [PMID: 32875552 DOI: 10.1002/ijc.33278] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/22/2020] [Accepted: 08/12/2020] [Indexed: 12/21/2022]
Abstract
In Ethiopia, cervical cancer is the second leading cause of morbidity and mortality from all cancers in women. Persistent infection with human papillomaviruses (HPV) plays a key role in the development of cervical intraepithelial neoplasia and invasive cervical cancer. To establish baseline data on the population-based prevalence of HPV infection and genotype distribution, we investigated cervical HPV epidemiology among rural women. This population-based study was conducted among rural women aged 30-49 years in Butajira, south-central Ethiopia. A total of 893 samples were tested from 1020 screened women. A self-sampling device (Evalyn Brush, Rovers, Oss, The Netherlands) was used and HPV presence and genotype was determined using multiplexed genotyping (MPG) by BSGP5+/6+ PCR with Luminex read out. The HPV positivity rate was 23.2% (95% CI: 23.54-22.86%) and 20.5% (95% CI = 20.79-20.21) and 10.3% (95% CI = 10.52-10.08) women were high-risk (hr- and low-risk (lr-) HPV positive, respectively. Fifty five (7.2%) of the women showed multiple hr-HPV infections. Age-specific hr-HPV infection peaked in the age-group 30- to 34 years old (58.6%) and decreased in 35-39, 40-44 and 45-49 years to 20.4%, 4.5% and 3.8% respectively. The top five prevalent hr-HPV genotypes were HPV16 (57.1%), 35 (20.3%), 52 (15.8%), 31 (14.1%), and 45 (9.6%) in the Butajira district. As a first population-based study in the country, our results can serve as valuable reference to guide nationwide cervical cancer screening and HPV vaccination programs in Ethiopia.
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Affiliation(s)
- Brhanu Teka
- Department of Microbiology, Immunology and Parasitology School of Medicine College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Muluken Gizaw
- Addis Ababa University, School of Public Health, Department of Preventive Medicine, Addis Ababa, Ethiopia.,Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Friederike Ruddies
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Adamu Addissie
- Addis Ababa University, School of Public Health, Department of Preventive Medicine, Addis Ababa, Ethiopia
| | - Zewditu Chanyalew
- Department of Pathology, St.Paul Hospital Millennium Medical College, Ethiopia
| | - Anna Sophie Skof
- Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Sarah Thies
- Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Adane Mihret
- Department of Microbiology, Immunology and Parasitology School of Medicine College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Armauer Hansen Research Institute (AHRI), Ethiopia
| | - Eva Johanna Kantelhardt
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany.,Department of Gynaecology, Martin-Luther-University, Halle-, Wittenberg, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology School of Medicine College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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21
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Xu Q, Fang M, Zhu J, Dong H, Cao J, Yan L, Leonard F, Oppel F, Sudhoff H, Kaufmann AM, Albers AE, Qian X. Insights into Nanomedicine for Immunotherapeutics in Squamous Cell Carcinoma of the head and neck. Int J Biol Sci 2020; 16:2506-2517. [PMID: 32792853 PMCID: PMC7415431 DOI: 10.7150/ijbs.47068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023] Open
Abstract
Immunotherapies such as immune checkpoint blockade benefit only a portion of patients with head and neck squamous cell carcinoma. The multidisciplinary field of nanomedicine is emerging as a promising strategy to achieve maximal anti-tumor effect in cancer immunotherapy and to turn non-responders into responders. Various methods have been developed to deliver therapeutic agents that can overcome bio-barriers, improve therapeutic delivery into the tumor and lymphoid tissues and reduce adverse effects in normal tissues. Additional modification strategies also have been employed to improve targeting and boost cytotoxic T cell-based immune responses. Here, we review the state-of-the-art use of nanotechnologies in the laboratory, in advanced preclinical phases as well as those running through clinical trials assessing their advantages and challenges.
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Affiliation(s)
- Qiang Xu
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences. Hangzhou, P.R. China
| | - Meiyu Fang
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences. Hangzhou, P.R. China
| | - Jing Zhu
- Department of Clinical Laboratory, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences. Hangzhou, P.R. China
| | - Haoru Dong
- First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, P.R. China
| | - Jun Cao
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences. Hangzhou, P.R. China
| | - Lin Yan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, P.R. China
| | - Fransisca Leonard
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, USA
| | - Felix Oppel
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Bielefeld, Germany
| | - Holger Sudhoff
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Bielefeld, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas E Albers
- Department of Otolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Xu Qian
- Department of Clinical Laboratory, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences. Hangzhou, P.R. China
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Ruddies F, Gizaw M, Teka B, Thies S, Wienke A, Kaufmann AM, Abebe T, Addissie A, Kantelhardt EJ. Cervical cancer screening in rural Ethiopia: a cross- sectional knowledge, attitude and practice study. BMC Cancer 2020; 20:563. [PMID: 32552740 PMCID: PMC7298871 DOI: 10.1186/s12885-020-07060-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 06/11/2020] [Indexed: 01/03/2023] Open
Abstract
Background Cervical cancer is the fourth most common cancer among women worldwide. Sub- Saharan Africa has a high incidence, prevalence and mortality due to shortage and underutilization of screening facilities. This study aims to assess knowledge and attitude towards cervical cancer and its prevention, as well as practice of cervical cancer screening. Methods This cross-sectional community- based study was conducted in Butajira, Ethiopia in February 2018. Systematic cluster randomized sampling was used to select households from which women in the targeted age group of 30–49 years were invited to participate. Data was collected using a quantitative door to door approach. The questionnaire included socio-demographic data, obstetric history, general knowledge, risk factors, attitude and practice. Logistic regression was used to assess factors associated with knowledge, attitude and practice after dichotomizing the scores using the median as cut off point. Results Three hundred forty-two out of 354 women completed the interviewer administered questionnaire making the response rate 96.3%. 125 women (36%) were aware of cervical cancer and 14 (4.7%) knew symptoms. None of the women named HPV as a risk factor. 61% thought it was a deadly disease, 13.5% felt at risk of developing cervical cancer and 60.7% said cervical cancer is treatable. Eight women (2.3%) had previously been screened. 48.1% had a source of information concerning cervical cancer, of which 66.5% named nurses. Better knowledge was associated with 1–8 years of education (OR = 2.4; CI: 2.4–1.3), having a source of information (OR = 9.1, CI:4.0–20.6), use of contraceptives (OR = 2.3, CI: 1.3–4.0) and a higher income (OR = 1.009, CI: 1.00–1.01). Naming nurses (OR:5.0, CI:2.4–10.3), another source of information (OR = 3.3, CI:1.2–9.0), use of contraceptives (OR = 2.2, CI:1.2–3.8) and living in an urban area (OR = 3.3, CI:1.2–9.0) were associated with a positive attitude. Naming nurses (OR = 21,0, CI:10.4–42.3) and another source of information (OR = 5.8, CI:2.4–13.5) were associated with participating in cervical cancer screening. Conclusion Most women were unaware of cervical cancer, HPV-infection as a risk factor and did not feel susceptible to cervical cancer. As Health workers were the most commonly mentioned source of information, focus should be put on their further education.
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Affiliation(s)
- Friederike Ruddies
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany
| | - Muluken Gizaw
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany.,School of Public Health, Department of Preventive Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Brhanu Teka
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sarah Thies
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institutes of Health, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institutes of Health, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adamu Addissie
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany.,School of Public Health, Department of Preventive Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany.
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23
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Jede F, Brandt T, Gedefaw M, Wubneh SB, Abebe T, Teka B, Alemu K, Tilahun B, Azemeraw T, Gebeyehu A, Schmidt D, Pesic A, Kaufmann AM, Abebe B, Ayichew Z, Byczkowski M, Vaucher T, Sartor H, Andargie G, Bärnighausen T, von Knebel Doeberitz M, Bussmann H. Home-based HPV self-sampling assisted by a cloud-based electronic data system: Lessons learnt from a pilot community cervical cancer screening campaign in rural Ethiopia. Papillomavirus Res 2020; 9:100198. [PMID: 32416283 PMCID: PMC7240728 DOI: 10.1016/j.pvr.2020.100198] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/23/2020] [Accepted: 04/27/2020] [Indexed: 01/01/2023]
Abstract
Primary HPV testing and triage of HPV-positive women is an effective cervical cancer screening strategy. Such a multi-visit screening algorithm is also promising for community-based screening in resource-poor communities, provided a robust tracking system is in place. A cervical cancer screening campaign was conducted in a rural community in Ethiopia. All women aged 25–65 years were offered genital self-sampling using the Evalyn Brush®. Samples were HPV-DNA-tested at a central laboratory. Key indicators were captured on tablet computers and linked by a cloud-based information system. HPV-positive women were examined at the local clinic using portable colposcopy, p16/Ki-67 dual stain cytology and biopsy examination. CIN2+ women were referred for LEEP to the referral hospital. Of 749 enumerated age-eligible women 634 (85%, (95% CI 82–88)) consented to screening, 429 samples were adequate for HPV testing, giving a total testing coverage of 57% (95% CI 53–62). The hrHPV prevalence was 14% (95% CI 5–22), 72% (95% CI 60–84) attended the clinic for a triage examination. Home-based HPV-DNA self-sampling and clinic-based triage assisted by cloud-based information technology is feasible in rural Ethiopia. Key components of such strategy are broad community awareness, high competency of community workers, and establishment of an adequate self-sampling and HPV-DNA testing platform.
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Affiliation(s)
- Felix Jede
- Applied Tumor Biology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
| | - Theresa Brandt
- Applied Tumor Biology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
| | | | - Solomon Berhe Wubneh
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Brhanu Teka
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Binyam Tilahun
- Department of Health Informatics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Temesgen Azemeraw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | | | - Dietmar Schmidt
- Department of Cytopathology, Institute of Pathology, Viersen, Germany.
| | - Aleksandra Pesic
- Clinic for Gynecology, Charité - Berlin Institute of Health, Charite - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité - Berlin Institute of Health, Charite - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - Bewketu Abebe
- Department of Pathology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Zelalem Ayichew
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | | | - Timoté Vaucher
- École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
| | - Heike Sartor
- Applied Tumor Biology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
| | - Gashaw Andargie
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA; Africa Health Research Institute (AHRI), Somkhele and Durban, South Africa.
| | | | - Hermann Bussmann
- Applied Tumor Biology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
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24
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Gizaw M, Teka B, Ruddies F, Kassahun K, Worku D, Worku A, Wienke A, Mikolajczyk R, Jemal A, Kaufmann AM, Abebe T, Addissie A, Kantelhardt EJ. Reasons for Not Attending Cervical Cancer Screening and Associated Factors in Rural Ethiopia. Cancer Prev Res (Phila) 2020; 13:593-600. [PMID: 32371553 DOI: 10.1158/1940-6207.capr-19-0485] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/11/2019] [Accepted: 03/16/2020] [Indexed: 12/24/2022]
Abstract
Social, economic, and cultural factors have been associated with the level of participation in cervical cancer screening programs. This study identified factors associated with nonparticipation in cervical cancer screening, as well as reasons for not attending, in the context of a population-based, cluster-randomized trial in Ethiopia. A total of 2,356 women aged 30 to 49 years in 22 clusters were invited to receive one of two screening approaches, namely human papillomavirus (HPV) self-sampling or visual inspection with acetic acid (VIA). Participants and nonparticipants were analyzed according to their sociodemographic and economic characteristics. Reasons were determined for the refusal of women to participate in either screening method. More women in the VIA arm compared to the HPV arm declined participation in the screening [adjusted OR (AOR) 3.5; 95% confidence interval (CI), 2.6-4.8]. Women who declined attending screening were more often living in rural areas (AOR = 2.0; 95% CI, 1.1-3.5) and were engaged in informal occupations (AOR = 1.6; 95% CI, 1.1-2.4). The majority of nonattendants perceived themselves to be at no risk of cervical cancer (83.1%). The main reasons given for not attending screening for both screening approaches were lack of time to attend screening, self-assertion of being healthy, and fear of screening. We found that perceived time constraints and the perception of being at no risk of getting the disease were the most important barriers to screening. Living in rural settings and informal occupation were also associated with lower participation. Offering a swift and convenient screening service could increase the participation of women in cervical cancer screening at the community level.
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Affiliation(s)
- Muluken Gizaw
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.,Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Brhanu Teka
- Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Ethiopia
| | - Friederike Ruddies
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | | | - Dawit Worku
- Department of Gynecology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andreas Wienke
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Ahmedin Jemal
- Department of Intramural Research, American Cancer Society, Atlanta, Georgia
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité-Universitätmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Berlin and Berlin Institute of Health, Berlin, Germany
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Ethiopia
| | - Adamu Addissie
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.,Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Eva Johanna Kantelhardt
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany. .,Department of Gynecology, Martin-Luther-University, Halle-Wittenberg, Germany
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25
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Qian X, Leonard F, Wenhao Y, Sudhoff H, Hoffmann TK, Ferrone S, Kaufmann AM, Albers AE. Immunotherapeutics for head and neck squamous cell carcinoma stem cells. HNO 2020; 68:94-99. [PMID: 31996933 DOI: 10.1007/s00106-020-00819-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Cancer stem cell (CSC)-related therapy resistance has become a new obstacle to the successful application of cancer treatment and head and neck squamous cell carcinoma (HNSCC) is no exception to this finding. Head and neck squamous cell carcinoma is highly immune-suppressive, and recently the immune suppression and invasion of HNSCC-CSCs have been characterized. These characteristics have received research and clinical attention because they would enable the stratification of patients into specific cancer subtypes and, consequently, the establishment of new therapeutic approaches with improved efficacy. This review discusses the feasibility of CSC-targeted strategies and their incorporation with nanotechnology to improve the efficacy of cancer immunotherapy.
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Affiliation(s)
- X Qian
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China.,Department of Clinical Laboratory, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China.,Department of Clinical Laboratory, Zhejiang Cancer Hospital, Hangzhou, China.,Department of Otolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - F Leonard
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, USA
| | - Y Wenhao
- Department of Otolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - H Sudhoff
- Department of Otolaryngology, Head and Neck Surgery, Medizinische Fakultät OWL, Klinikum Bielefeld, Universität Bielefeld, Bielefeld, Germany
| | - T K Hoffmann
- Department of Otolaryngology, Head and Neck Surgery, University of Ulm, Ulm, Germany
| | - S Ferrone
- Department of Surgery, Massachussets General Hospital, Harvard Medical School, Boston, MA, USA
| | - A M Kaufmann
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A E Albers
- Department of Otolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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26
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Kolben TM, Etzel LT, Bergauer F, Hagemann I, Hillemanns P, Repper M, Kaufmann AM, Sotlar K, Kolben T, Helms HJ, Gallwas J, Mahner S, Dannecker C. A randomized trial comparing limited-excision conisation to Large Loop Excision of the Transformation Zone (LLETZ) in cervical dysplasia patients. J Gynecol Oncol 2019; 30:e42. [PMID: 30887760 PMCID: PMC6424847 DOI: 10.3802/jgo.2019.30.e42] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/21/2018] [Accepted: 11/28/2018] [Indexed: 11/30/2022] Open
Abstract
Objective To show noninferiority of a limited-excision (resection of the dysplastic lesion only) vs. classical Large Loop Excision of the Transformation Zone (LLETZ). Methods In this prospective, randomized, multicenter trial, women with human papillomavirus (HPV) positive cervical intraepithelial neoplasia grade 3 were randomized into two groups (1:1). Primary outcome was the rate of negative HPV tests after 6 months, secondary outcomes included cone size, complete resection rates as well as cytological and histological results after 6 and 12 months. A sample size of 1,000 was calculated to show noninferiority of the limited-excision compared to the LLETZ group using a noninferiority margin of 5%. Enrollment was stopped after 100 patients due to slow accrual. Results Patients in the limited-excision group did not show a lower number of negative HPV tests (78% [LLETZ]−80% [limited-excision]=−2%; 90% confidence interval=−15%, 12%). The limited-excision resulted in a substantially lower cone size (LLETZ: 1.97 mL vs. limited-excision: 1.02 mL; p<0.001) but higher numbers of involved margins (LLETZ: 8% vs. limited-excision: 20%). Although postoperative cytological results slightly differed, histological results were similar in both groups. One limited-excision patient received immediate re-conisation, whereas one patient in each group was scheduled for re-conisation after 6 months. Conclusion The limited-excision could represent a promising option to reduce the surgical extent of conisations while maintaining oncological safety. The trial was not sufficiently powered to reach statistical significance due to early termination. Nevertheless, the study provides important insights in the feasibility of a limited-excision and could serve as a pilot study for future trials. Trial Registration German Clinical Trials Register Identifier: DRKS00006169
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Affiliation(s)
- Theresa Maria Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany.
| | - Lea T Etzel
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Florian Bergauer
- Amedes MVZ for Gynecology and Pathology Munich GmbH, Munich, Germany
| | | | - Peter Hillemanns
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
| | - Monika Repper
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
| | - Andreas M Kaufmann
- Department for Gynecology, Charité-Universitaetsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Karl Sotlar
- Institute of Pathology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Hans Joachim Helms
- Department of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany
| | - Julia Gallwas
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Christian Dannecker
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
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Pesic A, Krings A, Hempel M, Preyer R, Kaufmann AM. Clinical performance of the HPV DNA Array genotyping assay in detection of CIN2+ lesions with BS GP5+/6+ MPG Luminex tested cervical samples. J Med Virol 2019; 92:113-118. [PMID: 31471920 DOI: 10.1002/jmv.25583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 08/21/2019] [Indexed: 11/12/2022]
Abstract
Human papillomavirus (HPV) detection is used for screening of cervical cancer and genotype-specific persistence has shown to be mandatory for dysplasia development. Aim of this study was to evaluate the clinical performance of HPV DNA Array for cervical intraepithelial neoplasia 2+ (CIN2+) lesion detection. HPV DNA Array is a polymerase chain reaction-based assay that targets E1 sequences of 29 HPV types (6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 44, 45, 51, 52, 53, 54, 56, 58, 59, 66, 67, 68, 69, 70, 73, 82, 85, and 97). The clinical evaluation was performed against the reference assay, BS-GP5+/6+ multiplex genotyping (MPG)-Luminex, with 600 cervical smear samples of a referral population. HPV DNA Array detected CIN2+ lesions with a sensitivity of 90.2%, identical to that of MPG-Luminex. Detection of CIN3+ lesions was with a sensitivity of 90.3%, as compared with 88.7% of MPG-Luminex. It demonstrated very good agreement for HPV detection, irrespective of type, of 91.5% (κ = 0.832). HPV DNA Array is a simple and robust assay, with a short protocol of 4 hours hands-on time and automated readout by ELISpot AiDot software. It permits testing of up to 96 samples in one run and may be considered for use in organized screening programs and low resource settings.
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Affiliation(s)
- Aleksandra Pesic
- Gynaecology Clinic, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin and Berlin Institute of Health, Berlin, Germany
| | - Amrei Krings
- Gynaecology Clinic, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin and Berlin Institute of Health, Berlin, Germany
| | | | | | - Andreas M Kaufmann
- Gynaecology Clinic, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin and Berlin Institute of Health, Berlin, Germany
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28
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Pesic A, Krings A, Schreckenberger C, Hempel M, Preyer R, Kaufmann AM. Analytical Evaluation of the Human Papillomavirus HPV DNA Array E1-Based Genotyping Assay. Intervirology 2019; 62:124-133. [PMID: 31487743 DOI: 10.1159/000502207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 07/18/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cervical cancer is caused by a persistent infection of human papillomavirus (HPV). Therefore, tests which detect the carcinogenic virus can be used for cervical cancer screening. OBJECTIVE This is the first evaluation of the HPV DNA Array (AID Diagnostika, Strassberg, Germany), an E1-based genotyping polymerase chain reaction (PCR) test for identification of 29 HPV types (6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 44, 45, 51, 52, 53, 54, 56, 58, 59, 66, 67, 68, 69, 70, 73, 82, 85, and 97). METHODS Analytical performance of the assay was assessed with cervical cancer cell lines with known HPV status, and preselected clinical cervical scrapings genotyped by multiplexed genotyping (MPG) with a Luminex readout (validated in-house assay). Intra- and inter-laboratory reproducibility experiments were performed to ensure the reliability of the assay. RESULTS HPV DNA Array identified the intrinsic HPV genotype in all cervical cancer cell lines and demonstrated a high sensitivity for HPV16 probe (1 cell per PCR reaction), as well as HPV18 and 45 probes (100 cells per PCR reaction). When compared with MPG, HPV DNA Array showed a good agreement of 92.2% for HPV detection irrespective of type (κ = 0.601), and demonstrated high agreement for HPV16 (80.7%, κ = 0.836) and HPV18 (86.7%, κ = 0.925). Furthermore, high intra-/inter-laboratory reproducibility was observed (90.9-100%). CONCLUSION HPV DNA Array showed high sensitivity for correct HPV genotype detection in experimental and clinical samples with a good correlation to the reference test. Since HPV DNA Array is based on a simple multiplexed PCR followed by reverse hybridization in a 96-well format and automated visual readout by AID ELISpot reader, it is capable of high throughput in a time-effective manner. HPV DNA Array could be considered for extended HPV genotyping of cervical smears.
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Affiliation(s)
- Aleksandra Pesic
- Gynaecology Clinic, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin and Berlin Institute of Health, Berlin, Germany
| | - Amrei Krings
- Gynaecology Clinic, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin and Berlin Institute of Health, Berlin, Germany
| | - Carola Schreckenberger
- Gynaecology Clinic, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin and Berlin Institute of Health, Berlin, Germany
| | | | | | - Andreas M Kaufmann
- Gynaecology Clinic, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin and Berlin Institute of Health, Berlin, Germany,
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29
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Guo F, Yang Z, Kulbe H, Albers AE, Sehouli J, Kaufmann AM. Inhibitory effect on ovarian cancer ALDH+ stem-like cells by Disulfiram and Copper treatment through ALDH and ROS modulation. Biomed Pharmacother 2019; 118:109371. [PMID: 31545281 DOI: 10.1016/j.biopha.2019.109371] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 08/18/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Disulfiram (DSF) is a drug used for treatment of alcoholism that has also displayed promising anti-cancer activity. It unfolds its effects by inhibiting the enzyme activity of aldehyde dehydrogenase (ALDH) isoforms. METHODS MTT assay, spheroid formation, clonogenicity assay, qRT-PCR, and ALDH enzyme activity analysis were performed using ovarian cancer cell lines IGROV1, SKOV3 and SKOV3IP1. Cell cycle analyses and measurement of intracellular reactive oxygen species (ROS) were carried out by flow cytometry. ALDH+ and ALDH- cells were isolated by FACS sorting. RESULTS ALDH activity was inhibited in ovarian cancer stem cells (the proportion of ALDH+ cells was reduced from 21.7% to 0.391%, 8.4% to 0%, 6.88% to 0.05% in cell lines IGROV1, SKOV3, and SKOV3IP1, respectively). DSF with or without the cofactor copper (Cu2+) exhibited cytotoxicity dose- and time-dependent and enhanced cisplatin-induced apoptosis. DSF + Cu2+ increased intracellular ROS levels triggering apoptosis of ovarian cancer stem cells (CSC). Significantly more colony and spheroid formation was observed in ALDH+ compared with ALDH- cells (P < 0.01). Moreover, ALDH+ cells were more resistant to cisplatin treatment compared with ALDH-cells (P < 0.05) and also exhibited a lower basal level of ROS. However, no significant difference in ROS accumulation nor in cellular viability was observed in ALDH + cells in comparison to ALDH- cells after pre-treatment with DSF (0.08 μM). CONCLUSION Our findings provide evidence that DSF might be employed as a novel adjuvant chemotherapeutic agent in combination with cisplatin for treatment of ovarian cancer.
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Affiliation(s)
- Fang Guo
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Zhi Yang
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Hagen Kulbe
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas E Albers
- Department of Otolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jalid Sehouli
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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Agorastos T, Chatzistamatiou K, Tsertanidou A, Mouchtaropoulou E, Pasentsis K, Kitsou A, Moysiadis T, Moschaki V, Skenderi A, Katsiki E, Aggelidou S, Venizelos I, Ntoula M, Daponte A, Vanakara P, Garas A, Stefos T, Vrekoussis T, Lymberis V, Kontomanolis EN, Makrigiannakis A, Manidakis G, Deligeoroglou E, Panoskaltsis T, Decavalas GO, Michail G, Kalogiannidis I, Koukoulis G, Zempili P, Halatsi D, Truva T, Piha V, Agelena G, Chronopoulou A, Vaitsi V, Chatzaki E, Paschopoulos M, Adonakis G, Kaufmann AM, Hadzidimitriou A, Stamatopoulos K. Implementation of HPV-based Cervical Cancer Screening Combined with Self-sampling Using a Midwifery Network Across Rural Greece: The GRECOSELF Study. Cancer Prev Res (Phila) 2019; 12:701-710. [DOI: 10.1158/1940-6207.capr-19-0192] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/24/2019] [Accepted: 08/08/2019] [Indexed: 11/16/2022]
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Abdelaziz MO, Ossmann S, Kaufmann AM, Leitner J, Steinberger P, Willimsky G, Raftery MJ, Schönrich G. Development of a Human Cytomegalovirus (HCMV)-Based Therapeutic Cancer Vaccine Uncovers a Previously Unsuspected Viral Block of MHC Class I Antigen Presentation. Front Immunol 2019; 10:1776. [PMID: 31417555 PMCID: PMC6682651 DOI: 10.3389/fimmu.2019.01776] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/15/2019] [Indexed: 12/12/2022] Open
Abstract
Human cytomegalovirus (HCMV) induces a uniquely high frequency of virus-specific effector/memory CD8+ T-cells, a phenomenon termed “memory inflation”. Thus, HCMV-based vaccines are particularly interesting in order to stimulate a sustained and strong cellular immune response against cancer. Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor with high lethality and inevitable relapse. The current standard treatment does not significantly improve the desperate situation underlining the urgent need to develop novel approaches. Although HCMV is highly fastidious with regard to species and cell type, GBM cell lines are susceptible to HCMV. In order to generate HCMV-based therapeutic vaccine candidates, we deleted all HCMV-encoded proteins (immunoevasins) that interfere with MHC class I presentation. The aim being to use the viral vector as an adjuvant for presentation of endogenous tumor antigens, the presentation of high levels of vector-encoded neoantigens and finally the repurposing of bystander HCMV-specific CD8+ T cells to fight the tumor. As neoantigen, we exemplarily used the E6 and E7 proteins of human papillomavirus type 16 (HPV-16) as a non-transforming fusion protein (E6/E7) that covers all relevant antigenic peptides. Surprisingly, GBM cells infected with E6/E7-expressing HCMV-vectors failed to stimulate E6-specific T cells despite high level expression of E6/E7 protein. Further experiments revealed that MHC class I presentation of E6/E7 is impaired by the HCMV-vector although it lacks all known immunoevasins. We also generated HCMV-based vectors that express E6-derived peptide fused to HCMV proteins. GBM cells infected with these vectors efficiently stimulated E6-specific T cells. Thus, fusion of antigenic sequences to HCMV proteins is required for efficient presentation via MHC class I molecules during infection. Taken together, these results provide the preclinical basis for development of HCMV-based vaccines and also reveal a novel HCMV-encoded block of MHC class I presentation.
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Affiliation(s)
- Mohammed O Abdelaziz
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sophia Ossmann
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Judith Leitner
- Division of Immune Receptors and T Cell Activation, Institute of Immunology, Medical University of Vienna, Vienna, Austria
| | - Peter Steinberger
- Division of Immune Receptors and T Cell Activation, Institute of Immunology, Medical University of Vienna, Vienna, Austria
| | - Gerald Willimsky
- Institute of Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,German Cancer Research Center, Heidelberg, Germany.,German Cancer Consortium, Partner Site Berlin, Berlin, Germany
| | - Martin J Raftery
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Günther Schönrich
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Gizaw M, Teka B, Ruddies F, Abebe T, Kaufmann AM, Worku A, Wienke A, Jemal A, Addissie A, Kantelhardt EJ. Uptake of Cervical Cancer Screening in Ethiopia by Self-Sampling HPV DNA Compared to Visual Inspection with Acetic Acid: A Cluster Randomized Trial. Cancer Prev Res (Phila) 2019; 12:609-616. [PMID: 31337647 DOI: 10.1158/1940-6207.capr-19-0156] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 05/23/2019] [Accepted: 07/16/2019] [Indexed: 12/24/2022]
Abstract
In Ethiopia, the standard method of cervical cancer screening is using Visual Inspection with Acetic Acid (VIA). Self-collection-based human papillomavirus (HPV) testing is assumed to improve the uptake of screening, especially for hard to reach populations. We investigated whether HPV DNA testing with the self-collection of cervical samples would be associated with increased uptake and adherence to procedures at the population level compared with VIA within defined rural population in Ethiopia. A total of 22 clusters (comprising 2,356 women ages 30-49 years) were randomized in two arms. Following the community mobilization, women of the clusters were invited to go either to the local health post for a self-collection-based HPV DNA testing (arm A) or Butajira Hospital for VIA screening (arm B). In the HPV arm, of the 1,213 sensitized women, 1,020 (84.1%) accessed the health post for self-sampling compared with the VIA arm, where 575 of 1,143 (50.5%) visited the hospital for VIA (P < 0.0001). Of those women who attended the VIA and HPV arms, 40% and 65.4% adhered to all procedures expected after screening, respectively. Out of women positive for high risk HPV, 122 (85%) attended VIA as a follow-up test. The trial demonstrated significantly higher levels of population-based uptake and adherence for self-collection HPV testing. Women were more receptive for VIA after their HPV testing result was positive. Self-collection HPV testing can be done at the local health facility and may significantly improve the uptake of cervical cancer screening in Ethiopia.
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Affiliation(s)
- Muluken Gizaw
- Addis Ababa University, School of Public Health, Department of Preventive Medicine, Ethiopia.,Institute of Medical Epidemiology, Biometrics and Informatics Martin-Luther-University, Halle-Wittenberg, Germany
| | - Brhanu Teka
- Addis Ababa University, School of Medicine, Department of Microbiology, Immunology and Parasitology, Ethiopia
| | - Friederike Ruddies
- Institute of Medical Epidemiology, Biometrics and Informatics Martin-Luther-University, Halle-Wittenberg, Germany
| | - Tamrat Abebe
- Addis Ababa University, School of Medicine, Department of Microbiology, Immunology and Parasitology, Ethiopia
| | - Andreas M Kaufmann
- Department of Gynecology, Charité-Universitätmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Berlin and Berlin Institute of Health, Berlin, Germany
| | - Alemayehu Worku
- Addis Ababa University, School of Public Health, Department of Preventive Medicine, Ethiopia
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biometrics and Informatics Martin-Luther-University, Halle-Wittenberg, Germany
| | - Ahmedin Jemal
- Department of Intramural Research, American Cancer Society, Atlanta, Georgia
| | - Adamu Addissie
- Addis Ababa University, School of Public Health, Department of Preventive Medicine, Ethiopia
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biometrics and Informatics Martin-Luther-University, Halle-Wittenberg, Germany. .,Department of Gynecology Martin-Luther-University, Halle-Wittenberg, Germany
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Krings A, Dunyo P, Pesic A, Tetteh S, Hansen B, Gedzah I, Wormenor CM, Amuah JE, Behnke AL, Höfler D, Pawlita M, Kaufmann AM. Characterization of Human Papillomavirus prevalence and risk factors to guide cervical cancer screening in the North Tongu District, Ghana. PLoS One 2019; 14:e0218762. [PMID: 31246997 PMCID: PMC6597158 DOI: 10.1371/journal.pone.0218762] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 06/07/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION This population-based study aimed to fill the knowledge gap on Human Papillomavirus (HPV) prevalence and associated sociodemographic risk factors of the general population in the North Tongu District, Ghana. These results are needed to guide cervical cancer prevention efforts, as the leading type of female cancers. METHODS A cross-sectional study including 2002 women in the North Tongu District, Ghana investigated HPV prevalence and associated sociodemographic risk factors. Women were recruited by geographical distribution through the local community-based health system and samples collected using a self-sampling device. For HPV genotyping BSGP5+/6+-PCR with Luminex-MPG readout was used. Multivariate logistic regression analyzed sociodemographic risk factors for HPV positivity. RESULTS Of 2002 self-collected samples, 1943 were eligible, contained sufficient DNA and provided valid HPV genotyping results. Prevalence of single high risk HPV types was 32.3% and of multiple high risk types 9.7%. The five most common detected HPV types were HPV16 (7.4%; 95%CI: 6.3-8.7), HPV52 (7.2%; 95%CI: 6.1-8.5), HPV35 (4.8%; 95%CI: 3.9-5.8), HPV59 (4.7%; 95%CI: 3.8-5.8), HPV56 (3.9%; 95%CI: 3.1-4.8). Highest prevalence was observed among women aged 18-24 years, while age 25-54 years was inversely associated with high risk HPV positivity in multivariate analysis. Sociodemographic risk factors identified were i) having any sexual partner, ii) more partners increased the odds for high risk HPV positivity, iii) independently from this marital status, in particular not being married. DISCUSSION & CONCLUSION Most importantly, the high risk HPV prevalence detected from this study is higher than estimates reported for Western Africa. This needs be considered, when deciding on the cervical cancer screening algorithms introduced on a wider scale. Follow-up and triage, depending on the methods chosen, can easily overburden the health system. Self-sampling worked well and provided adequate samples for HPV-based screening. Women with increasing number of sexual partners and not being married were found to have higher odds of being high risk HPV positive, therefore could be a higher prioritized screening target group.
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Affiliation(s)
- Amrei Krings
- Clinic for Gynecology, Laboratory for Gynecologic Tumor Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | | | - Aleksandra Pesic
- Clinic for Gynecology, Laboratory for Gynecologic Tumor Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | | | | | - Isaac Gedzah
- Catholic Hospital Battor, Battor, Volta Region, Ghana
| | | | - Joseph E. Amuah
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Anna-Lisa Behnke
- Clinic for Gynecology, Laboratory for Gynecologic Tumor Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Daniela Höfler
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas M. Kaufmann
- Clinic for Gynecology, Laboratory for Gynecologic Tumor Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
- * E-mail:
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Qian X, Nguyen DT, Dong Y, Sinikovic B, Kaufmann AM, Myers JN, Albers AE, Graviss EA. Prognostic Score Predicts Survival in HPV-Negative Head and Neck Squamous Cell Cancer Patients. Int J Biol Sci 2019; 15:1336-1344. [PMID: 31337965 PMCID: PMC6643134 DOI: 10.7150/ijbs.33329] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/17/2019] [Indexed: 12/11/2022] Open
Abstract
Although patients having head and neck squamous cell carcinoma (HNSCC) have high mortality, standardized prognostic tools are unavailable. As such, having a validated simple prognostic scoring system to help predict mortality in these high-risk patients is urgently needed. The current study aimed to develop and internally validate a prognostic scoring system for overall mortality in human papillomavirus (HPV)-independent HNSCC patients. Data on 400 consecutive patients from the Cancer Genome Atlas database with a known HPV-RNA negative status were analyzed. A prognostic model to predict patient overall mortality was developed using the logistic regression beta coefficients and a simple risk score was created. The model was internally validated using bootstrap validation with 2000 replications. Five covariates (age, pT, pN, perineural invasion, and EAp53 score) were used in the development of the mortality risk score in the final model. Three risk groups were stratified based on the prognostic scores: low-risk (<96 points), medium-risk (96-121 points), and high-risk (≥122 points) with a survival of 76%, 62% and 35%, respectively. The proposed model presented good discrimination in both the development (AUC = 0.76; 95% CI 0.70, 0.81) and bootstrap validation (AUC = 0.76; 95% CI 0.70, 0.81) with a non-significant Hosmer-Lemeshow chi-square of 6.17 (p = 0.63). The proposed prognostic scoring system is easy to use to predict patient overall mortality and could also help in the appropriate allocation of medical resources while managing HNSCC patients. External validation (including re-calibration if needed) should be conducted to test the model's generalizability in different populations.
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Affiliation(s)
- Xu Qian
- Division of Molecular Diagnostics, Department of Laboratory Medicine, Zhejiang Cancer Hospital, Hangzhou 310022, P.R. China.,Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin 12200, Germany.,Key Laboratory of Laboratory Medicine, Ministry of Education of China, Zhejiang Provincial Key Laboratory of Medical Genetics, Wenzhou Medical University, Wenzhou 325035, P.R. China
| | - Duc T Nguyen
- Houston Methodist Research Institute, Houston 77030, United States
| | - Yue Dong
- Key Laboratory of Laboratory Medicine, Ministry of Education of China, Zhejiang Provincial Key Laboratory of Medical Genetics, Wenzhou Medical University, Wenzhou 325035, P.R. China
| | - Branko Sinikovic
- Department of Craniomaxillofacial, Oral and Plastic Surgery, Klinikum Ernst von Bergmann, Potsdam 14467, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Berlin Institute of Health, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin 12200, Germany
| | - Jeffrey N Myers
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston 77030, United States
| | - Andreas E Albers
- Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin 12200, Germany
| | - Edward A Graviss
- Houston Methodist Research Institute, Houston 77030, United States
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Krings A, Boateng G, Dunyo P, Amuah JE, Adams RA, Adunyame L, Nkansah DO, Wormenor CM, Hansen BT, Gedzah I, Asmah RH, Wiredu EK, Kaufmann AM. Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approaches. Papillomavirus Res 2019; 7:45-51. [PMID: 30625379 PMCID: PMC6350109 DOI: 10.1016/j.pvr.2018.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/20/2018] [Accepted: 12/26/2018] [Indexed: 11/14/2022]
Abstract
Persistent Human Papillomavirus (HPV) infection is a prerequisite for cervical cancer development. Few studies investigated clearance of high-risk HPV in low-and-middle-income countries. Our study investigated HPV clearance and persistence over four years in women from North Tongu District, Ghana. In 2010/2011, cervical swabs of 500 patients were collected and HPV genotyped (nested multiplex PCR) in Accra, Ghana. In 2014, 104 women who previously tested positive for high-risk HPV and remained untreated were re-tested for HPV. Cytobrush samples were genotyped (GP5+/6+ PCR & Luminex-MPG readout) in Berlin, Germany. Positively tested patients underwent colposcopy and treatment if indicated. Of 104 women, who tested high-risk HPV+ in 2010/2011, seven (6,7%; 95%CI: 2.7–13.4%) had ≥1 persistent high-risk‐infection after ~4 years (mean age 39 years). Ninety-seven (93,3%; 95%CI: 86.6–97.3%) had cleared the original infection, while 22 (21.2%; 95%CI: 13.8–30.3%) had acquired new high-risk infections with other genotypes. Persistent types found were HPV 16, 18, 35, 39, 51, 52, 58, and 68. Among those patients, one case of CIN2 (HPV 68) and one micro-invasive cervical cancer (HPV 16) were detected. This longitudinal observational data suggest that single HPV screening rounds may lead to over-referral. Including type-specific HPV re-testing or additional triage methods could help reduce follow-up rates. High-risk HPV genotype-specific clearance rates of 93.3% after 4 years. New infections with other high-risk HPV were 21.2%. New infections may overestimate women at risk if non-genotyping repeat HPV-testing is used for triage. Type-specific HPV genotyping reduces follow-up rates, for example by colposcopy.
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Affiliation(s)
- Amrei Krings
- Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
| | - Gifty Boateng
- National Public Health and Reference Laboratory, Korle Bu, Accra, Ghana
| | | | - Joseph E Amuah
- School of Epidemiology & Public Health, University of Ottawa, Canada
| | - Rashid A Adams
- School of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, Ghana.
| | - Lois Adunyame
- School of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, Ghana
| | - Dinah O Nkansah
- School of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, Ghana
| | | | | | | | - Richard H Asmah
- School of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, Ghana.
| | - Edwin K Wiredu
- School of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, Ghana.
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
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Qian X, Nie X, Wollenberg B, Sudhoff H, Kaufmann AM, Albers AE. Heterogeneity of Head and Neck Squamous Cell Carcinoma Stem Cells. Adv Exp Med Biol 2019; 1139:23-40. [PMID: 31134493 DOI: 10.1007/978-3-030-14366-4_2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Current systemic cancer treatment in head and neck squamous cell carcinoma (HNSCC) is moving toward more personalized approaches such as de-escalation protocols human-papilloma-virus dependent HNSCC or application of checkpoint inhibitors. However, these treatments have been challenged by cancer stem cells (CSC), a small population within the bulk tumor, which are leading to treatment failure, tumor recurrence, or metastases. This review will give an overview of the characteristics of HNSCC-CSC. Specifically, the mechanisms by which HNSCC-CSC induce tumor initiation, progression, recurrence, or metastasis will be discussed. Although evidence-based treatment options targeting HNSCC-CSC specifically are still being sought for, they warrant a promise for additional and sustainable treatment options where for HNSCC patients where others have failed.
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Affiliation(s)
- Xu Qian
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institutes of Health, Berlin, Germany.,Division of Molecular Diagnostics, Department of Laboratory Medicine, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Xiaobo Nie
- Key Laboratory of Receptors-Mediated Gene Regulation and Drug Discovery, School of Basic Medical Sciences, Henan University, Kaifeng, People's Republic of China
| | - Barbara Wollenberg
- University Hospital Schleswig Holstein, Campus Lübeck, Clinic for Otorhinolaryngology - Head and Neck Surgery, Lübeck, Germany
| | - Holger Sudhoff
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Bielefeld, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institutes of Health, Berlin, Germany
| | - Andreas E Albers
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institutes of Health, Berlin, Germany.
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Guo F, Yang Z, Xu J, Sehouli J, Albers AE, Kaufmann AM. Cytotoxic effects of disulfiram and synergism with cisplatin on ovarian cancer cells in vitro. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- F Guo
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - Z Yang
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - J Xu
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - J Sehouli
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Berlin, Deutschland
| | - AE Albers
- Charité-Universitätsmedizin Berlin/Klinik für Hals, Nasen, Ohrenheilkunde, Berlin, Deutschland
| | - AM Kaufmann
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
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Yang Z, Guo F, Xu J, Sehouli J, Albers AE, Kaufmann AM. Disulfiram treatment targeting cancer stem cells in breast cancer cell lines. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Z Yang
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - F Guo
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - J Xu
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - J Sehouli
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Berlin, Deutschland
| | - AE Albers
- Charité-Universitätsmedizin Berlin/Klinik für Hals, Nasen, Ohrenheilkunde, Berlin, Deutschland
| | - AM Kaufmann
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
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Saidi J, Kaufmann AM, Bendahhou K, Bekkali R, Chami Y, Belakhal A, Ahmadaye IK, Lakehayli Z, Benider A, Sehouli J. Cervical cancer screening feasibility study MorocOncoE6 comparing VIA with molecular HPV oncogene expression testing. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- J Saidi
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - AM Kaufmann
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - K Bendahhou
- Direction régionale du ministère de la Santé, Casablanca, Marokko
| | - R Bekkali
- Lalla Salma Fondation Prevention et Traitement des Cancers, Rabat, Marokko
| | - Y Chami
- Lalla Salma Fondation Prevention et Traitement des Cancers, Rabat, Marokko
| | - A Belakhal
- Service de prévention et du contrôle du cancer, ministère de la Santé, Rabat, Marokko
| | - IK Ahmadaye
- Center Mohammed VI, Cancer Center, CHU Ibn Rochd, Casablanca, Marokko
| | - Z Lakehayli
- Center Mohammed VI, Cancer Center, CHU Ibn Rochd, Casablanca, Marokko
| | - A Benider
- Center Mohammed VI, Cancer Center, CHU Ibn Rochd, Casablanca, Marokko
| | - J Sehouli
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Berlin, Deutschland
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Sarina S, Kube T, Yao W, Xu J, Sehouli J, Kaufmann AM. Validation of IFN-γ/IL-2 FluoroSpot assay for monitoring HPV L1-specific immuneresponses in Cervarix™ vaccinees. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Sarina
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - T Kube
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - W Yao
- Charité-Universitätsmedizin Berlin/Klinik für Hals, Nasen, Ohrenheilkunde, Berlin, Deutschland
| | - J Xu
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - J Sehouli
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Berlin, Deutschland
| | - AM Kaufmann
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
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Ossmann S, Koch I, Kellner M, Böcher O, Sehouli J, Kaufmann AM. HPV E7 Onkoprotein-basierter molekularer Triage Test für den Einsatz im Zervixkarzinom-Screening. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Ossmann
- Klinik für Gynäkologie, Charité-Universitätsmedizin Berlin, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - I Koch
- Mikrogen GmbH, Neuried, Deutschland
| | | | - O Böcher
- Mikrogen GmbH, Neuried, Deutschland
| | - J Sehouli
- Klinik für Gynäkologie, Charite-Universitätsmedizin Berlin, Berlin, Deutschland
| | - AM Kaufmann
- Klinik für Gynäkologie, Charité-Universitätsmedizin Berlin, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
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Wagner A, Richter R, Siedentopf JP, Henrich W, Taube E, Kaufmann AM, Rohr I. High-risk HPV DNA genotyping for primary cervical cancer screening compared with cytology and colposcopy in HIV-positive women: preliminary results. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Wagner
- Charité Universitätsklinikum, Campus Virchow-Klinikum, Geburtsmedizin, Berlin, Deutschland
| | - R Richter
- Charité Universitätsklinikum, Campus Virchow-Klinikum, Gynäkologie, Berlin, Deutschland
| | - JP Siedentopf
- Charité Universitätsklinikum, Campus Virchow-Klinikum, Geburtsmedizin, Berlin, Deutschland
| | - W Henrich
- Charité Universitätsklinikum, Campus Virchow-Klinikum, Geburtsmedizin, Berlin, Deutschland
| | - E Taube
- Charité Universitätsmedizin Berlin, Pathologie, Berlin, Deutschland
| | - AM Kaufmann
- Charité Universitätsklinikum, Campus Virchow-Klinikum, Gynäkologie, Berlin, Deutschland
- Charité Universitätsmedizin Berlin, Gynäkologische Tumoronkologie, Berlin, Deutschland
| | - I Rohr
- Charité Universitätsklinikum, Campus Virchow-Klinikum, Geburtsmedizin, Berlin, Deutschland
- Charité Universitätsklinikum, Campus Virchow-Klinikum, Gynäkologie, Berlin, Deutschland
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Pesic A, Krings A, Hempel M, Preyer R, Chatzistamatiou K, Agorastos T, Sehouli J, Kaufmann AM. CIN2+ detection by HPV DNA array genotyping assay. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Pesic
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - A Krings
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
| | - M Hempel
- AID/GenID Diagnostika, Strassberg, Deutschland
| | - R Preyer
- AID/GenID Diagnostika, Strassberg, Deutschland
| | - K Chatzistamatiou
- IVth University Clinic of Obstetrics and Gynaecology, Hippokration General Hospital, Aristotle University, Thessaloniki, Griechenland
| | - T Agorastos
- IVth University Clinic of Obstetrics and Gynaecology, Hippokration General Hospital, Aristotle University, Thessaloniki, Griechenland
| | - J Sehouli
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Berlin, Deutschland
| | - AM Kaufmann
- Charité-Universitätsmedizin Berlin/Klinik für Gynäkologie, Labor Gynäkologische Tumorimmunologie, Berlin, Deutschland
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Zeiler FA, Lo BWY, Akoth E, Silvaggio J, Kaufmann AM, Teitelbaum J, West M. Predicting Outcome in Subarachnoid Hemorrhage (SAH) Utilizing the Full Outline of UnResponsiveness (FOUR) Score. Neurocrit Care 2018; 27:381-391. [PMID: 28382509 DOI: 10.1007/s12028-017-0396-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Existing scoring systems for aneurysmal subarachnoid hemorrhage (SAH) patients fail to accurately predict patient outcome. Our goal was to prospectively study the Full Outline of UnResponsiveness (FOUR) score as applied to newly admitted aneurysmal SAH patients. METHODS All adult patients presenting to Health Sciences Center in Winnipeg from January 2013 to July 2015 (2.5 year period) with aneurysmal SAH were prospectively enrolled in this study. All patients were followed up to 6 months. FOUR score was calculated upon admission, with repeat calculation at 7 and 14 days. The primary outcomes were: mortality, as well as dichotomized 1- and 6-month Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) values. RESULTS Sixty-four patients were included, with a mean age of 54.2 years (range 26-85 years). The mean FOUR score upon admission pre- and post-external ventricular drain (EVD) was 10.3 (range 0-16) and 11.1 (range 3-16), respectively. There was a statistically significant association between pre-EVD FOUR score (total, eye, respiratory and motor sub-scores) with mortality, 1-month GOS, and 6-month GOS/mRS (p < 0.05 in all). The day 7 total, eye, respiratory, and motor FOUR scores were associated with mortality, 1-month GOS/mRS, and 6-month GOS/mRS (p < 0.05 in all). The day 14 total, eye, respiratory, and motor FOUR scores were associated with 6-month GOS (p < 0.05 in all). The day 7 cumulative FOUR score was associated with the development of clinical vasospasm (p < 0.05). CONCLUSIONS The FOUR score at admission and day 7 post-SAH is associated with mortality, 1-month GOS/mRS, and 6-month GOS/mRS. The FOUR score at day 14 post-SAH is associated with 6-month GOS. The brainstem sub-score was not associated with 1- or 6-month primary outcomes.
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Affiliation(s)
- F A Zeiler
- Section of Neurosurgery, Department of Surgery, Health Sciences Center, University of Manitoba, GB-1 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada. .,Clinician Investigator Program, University of Manitoba, Winnipeg, MB, Canada. .,Division of Anaesthesia, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
| | - B W Y Lo
- Section of Neurosurgery and Neurocritical Care, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.,Section of Neurocritical Care, Montreal Neurological Institute, Montreal, QC, Canada
| | - E Akoth
- Section of Neurosurgery, Department of Surgery, Health Sciences Center, University of Manitoba, GB-1 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada
| | - J Silvaggio
- Section of Neurosurgery, Department of Surgery, Health Sciences Center, University of Manitoba, GB-1 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada
| | - A M Kaufmann
- Section of Neurosurgery, Department of Surgery, Health Sciences Center, University of Manitoba, GB-1 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada
| | - J Teitelbaum
- Section of Neurocritical Care, Montreal Neurological Institute, Montreal, QC, Canada
| | - M West
- Section of Neurosurgery, Department of Surgery, Health Sciences Center, University of Manitoba, GB-1 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada
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Albers AE, Qian X, Kaufmann AM, Mytilineos D, Ferris RL, Hoffmann TK, DeLeo AB. Phenotype of p53 wild-type epitope-specific T cells in the circulation of patients with head and neck cancer. Sci Rep 2018; 8:10716. [PMID: 30013227 PMCID: PMC6048165 DOI: 10.1038/s41598-018-29067-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/02/2018] [Indexed: 11/23/2022] Open
Abstract
CD8+ cytotoxic T-cell (CTL) specific for non-mutated, wild type (wt) sequence p53 peptides derived from wt or mutant p53 molecules expressed in head and neck squamous cell carcinomas (HNSCC) have been detected in the circulation of patients with this disease. The frequency and differentiation/maturation phenotypes of these anti-tumor specific CTL can reflect the host’s immunologic response. Therefore, we investigated the frequency and phenotypes of wt sequence p53 peptide-specific CTL in patients with HNSCC (n = 33) by flow cytometric analysis using HLA-A*0201 tetrameric peptides (tet) complexed with the wt sequence p53264–272 or p53149–157 peptide and co-staining with phenotypic markers. One main finding was that increasing frequencies of tet+ CD8+ T cells in patients’ circulation correlated with increased frequencies of inactive naïve tet+ cells, while those with effector memory and terminally differentiated phenotypes, which are associated with positive anti-tumor immune responses, decreased. We also found that the frequency of circulating tet+ CD8+ T cells negatively correlated with p53 expression in tumor tissues and tumor stage. Our findings support further clinical-based investigations to define the frequencies and phenotypes of wt sequence p53 peptide-specific CD8+ T cells to predict disease severity, enhance selection of patients for inclusion in vaccination trials and highlight prerequisites to enhance immune susceptibility by activation of inactive naïve tet+ T cells and/or enhancing circulating effector T cell activity by checkpoint blockage.
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Affiliation(s)
- Andreas E Albers
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
| | - Xu Qian
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Daphne Mytilineos
- Department of Otolaryngology, Head and Neck Surgery, University of Ulm, Ulm, Germany
| | - Robert L Ferris
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Thomas K Hoffmann
- Department of Otolaryngology, Head and Neck Surgery, University of Ulm, Ulm, Germany
| | - Albert B DeLeo
- University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.,Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
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46
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Qian X, Nie X, Yao W, Klinghammer K, Sudhoff H, Kaufmann AM, Albers AE. Reactive oxygen species in cancer stem cells of head and neck squamous cancer. Semin Cancer Biol 2018; 53:248-257. [PMID: 29935313 DOI: 10.1016/j.semcancer.2018.06.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/08/2018] [Accepted: 06/17/2018] [Indexed: 12/12/2022]
Abstract
One of the greatest challenges in systemic treatment of head and neck squamous cell carcinoma (HNSCC) is a small tumor cell population, namely, cancer stem-like cells (CSC). CSC can regenerate and maintain a heterogenic tumor by their self-renewal capacity. Their potential ability to be more resistant to and survival after chemo- and radiation therapy was also identified. Further studies have shown that reactive oxygen species (ROS) contribute to this CSC-associated resistance. In this review, we focus on the current knowledge of HNSCC-CSC, with regard to ROS as a possible and novel therapeutic approach in targeting CSC.
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Affiliation(s)
- Xu Qian
- Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany; Division of Molecular Diagnostics, Department of Laboratory Medicine, Zhejiang Cancer Hospital, Hangzhou, PR China; Key Laboratory of Laboratory Medicine, Ministry of Education, Zhejiang Provincial Key Laboratory of Medical Genetics, Wenzhou Medical University, Wenzhou, PR China
| | - Xiaobo Nie
- Key Laboratory of Receptors-Mediated Gene Regulation and Drug Discovery, School of Basic Medical Sciences, Henan University, Kaifeng, PR China
| | - Wenhao Yao
- Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Konrad Klinghammer
- Department of Hematology and Oncology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Holger Sudhoff
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Bielefeld, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Andreas E Albers
- Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany.
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47
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Krings A, Dückelmann AM, Moser L, Gollrad J, Wiegerinck M, Schweizer J, Kaufmann AM. Performance of OncoE6 cervical test with collection methods enabling self-sampling. BMC Womens Health 2018; 18:68. [PMID: 29783960 PMCID: PMC5963066 DOI: 10.1186/s12905-018-0559-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/01/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND The paradigm shift from cytological screening to Human Papillomavirus (HPV)-based screening for cervical cancer allows the introduction of new technologies in sample collection and diagnostics. The OncoE6™ Cervical Test (OncoE6 Test) is a rapid, easy-to-use lateral flow method detecting HPV16/18 E6 oncoproteins that has proven to detect high-grade cervical lesions with high specificity. If compatible with self-collection samples, this technology might allow for decentralized screening of hard-to-reach populations. METHODS For technical validation, cervicovaginal lavages were collected from 20 patients with confirmed HPV16+ or HPV18+ invasive cervical cancer. Cervical smears were collected by polyester-tipped swabs and cytobrushes. All samples were applied to the OncoE6 Test and cytobrush samples additionally genotyped. RESULTS Lavage, swab, and cytobrush revealed concordant outcome in 18/20 samples. HPV types corresponded with the HPV genotyping by GP5+/6+ PCR analyses. Due to a rare mutation found in the E6 antibody binding site one sample was not detected, another sample had very low cellularity. CONCLUSIONS Overall, vaginal lavages are technically adequate for the OncoE6 Test. Combining self-sampling with oncoprotein rapid testing to detect women with highest risk for severe dysplasia or cancer may allow for secondary cancer prevention in settings where other screening modalities were unsuccessful to date.
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Affiliation(s)
- Amrei Krings
- Clinic for Gynecology CCM/CBF, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Anna M Dückelmann
- Clinic for Gynecology CCM/CBF, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lutz Moser
- Department of Radiooncology, CBF, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Gollrad
- Department of Radiooncology, CBF, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | | | - Andreas M Kaufmann
- Clinic for Gynecology CCM/CBF, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. .,Gynäkologische Tumorimmunologie, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30 Room # 4503, 12200, Berlin, Germany.
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48
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Albers AE, Kaufmann AM. EGFR im Speichel: neuer Tumormarker für Plattenepithelkarzinom im Mund? Laryngorhinootologie 2018; 97:302-303. [DOI: 10.1055/s-0044-100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zanotti L et al. Epidermal growth factor receptor detection in serum and saliva as a diagnostic and prognostic tool in oral cancer. Laryngoscope 2017; 127:
E408–E414
Der EGF-Rezeptor (EGFR) ist ein Transmembranrezeptor mit intrinsischer Tyrosinkinase-Aktivität, der in allen Zellarten vorkommt. Die Überexpression des EGFR
ist bei verschiedenen Tumorarten nachweisbar, so auch beim Plattenepithelkarzinom im Mundraum (OSCC). Den diagnostischen und prognostischen Wert des EGFR
beim OSCC aus Serum und Speichel bestimmten italienische Ärzte der Universität von Brescia.
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Chatzistamatiou K, Moysiadis T, Vryzas D, Chatzaki E, Kaufmann AM, Koch I, Soutschek E, Boecher O, Tsertanidou A, Maglaveras N, Jansen-Duerr P, Agorastos T. Cigarette Smoking Promotes Infection of Cervical Cells by High-Risk Human Papillomaviruses, but not Subsequent E7 Oncoprotein Expression. Int J Mol Sci 2018; 19:ijms19020422. [PMID: 29385075 PMCID: PMC5855644 DOI: 10.3390/ijms19020422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 01/28/2018] [Accepted: 01/29/2018] [Indexed: 12/21/2022] Open
Abstract
Persistent cervical infection with high-risk human papillomaviruses (hrHPVs) is a necessary, but not sufficient, condition for the development of cervical cancer. Therefore, there are other co-factors facilitating the hrHPV carcinogenic process, one of which is smoking. To assess the effect of smoking on high-risk (hr) HPV DNA positivity and on the expression of HPV E7 oncoprotein, as a surrogate of persistent hrHPV infection, we used data from women recruited for the PIPAVIR project, which examined the role of E7 protein detection in cervical cancer screening. Women were tested for hrHPV DNA, using Multiplex Genotyping (MPG), and E7 protein, using a novel sandwich ELISA method, and gave information on their smoking habits. Among 1473 women, hrHPV prevalence was 19.1%. The odds ratio (OR) for hrHPV positivity of smokers compared to non-smokers was 1.785 (95% confidence intervals (CI): 1.365–2.332, p < 0.001). The ORs for E7 positivity, concerning hrHPV positive women, ranged from 0.720 to 1.360 depending on the E7 detection assay used, but this was not statistically significant. Smoking increases the probability of hrHPV infection, and smoking intensity is positively associated to this increase. Smoking is not related to an increased probability of E7 protein positivity for hrHPV positive women.
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Affiliation(s)
- Kimon Chatzistamatiou
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, 54642 Thessaloniki, Greece.
| | - Theodoros Moysiadis
- Institute of Applied Biosciences, Centre for Research & Technology-Hellas, 57001 Thessaloniki, Greece.
| | - Dimos Vryzas
- Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
| | - Ekaterini Chatzaki
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
| | - Andreas M Kaufmann
- Department of Gynecology, Charité-Universitaetsmedizin Berlin, Campus Benjamin Franklin, 10117 Berlin, Germany.
| | | | | | | | - Athena Tsertanidou
- 4th Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, 54642 Thessaloniki, Greece.
| | - Nikolaos Maglaveras
- Lab of Computing and Medical Informatics, Department of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Pidder Jansen-Duerr
- Research Institute for Biomedical Aging Research, University of Innsbruck, A-6020 Innsbruck, Austria.
| | - Theodoros Agorastos
- 4th Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, 54642 Thessaloniki, Greece.
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50
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Zurek Munk-Madsen M, Toft L, Kube T, Richter R, Ostergaard L, Søgaard OS, Tolstrup M, Kaufmann AM. Cellular immunogenicity of human papillomavirus vaccines Cervarix and Gardasil in adults with HIV infection. Hum Vaccin Immunother 2017; 14:909-916. [PMID: 29172992 PMCID: PMC5893199 DOI: 10.1080/21645515.2017.1407896] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Human papillomavirus (HPV) infection is a frequent cause of malignant and non-malignant disease, in particular among persons with HIV. HPV serotype-specific anti L1 antibodies protect against HPV infection but little is known about prophylactic HPV vaccine-induced cell-mediated immunity against HPV in high-risk individuals. We recently showed that both HPV vaccines (Gardasil® and Cervarix®) induce solid, serological immune responses in HIV-infected persons. This study aimed to characterize HPV-specific CD4 T cells in HIV-infected HPV-vaccine recipients, T cell responses being critical for B cell activation and antibody-isotype switching. Thirty HIV-infected patients on long-term antiretroviral treatment (ART) received 3 doses of either Cervarix (n = 15) or Gardasil (n = 15) vaccine at month 0, 1.5 and 6. Cryopreserved peripheral blood mononuclear cells (PBMC) from baseline, 7 and 12 months were subjected to 24-hour stimulation with specific pools of HPV L1-peptides (HPV6, 11, 16, 18, 31 and 45) and HPV E6/E7-peptide pools (HPV6/11 and HPV16/18). Fluorescence-activated cell sorting with intracellular staining (IC-FACS) against CD4, CD154, IL-2, and IFNγ was performed. Frequencies (%) of HPV-antigen specific CD4+ T cells (CD154+/IL-2+ or CD154+/ IFNγ+) were determined. Both HPV-vaccines significantly and comparably enhanced cell-mediated vaccine L1 antigen-specific immunity in HIV-positive adults receiving ART therapy at month 7 and 12 after first vaccine dose. This suggests that the vaccines induce CD4 T cellular memory despite HIV-induced immune compromisation.
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Affiliation(s)
- Maria Zurek Munk-Madsen
- a Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany.,b Department of Infectious Diseases , Aarhus University Hospital , Aarhus , Denmark
| | - Lars Toft
- b Department of Infectious Diseases , Aarhus University Hospital , Aarhus , Denmark
| | - Tina Kube
- a Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany
| | - Rolf Richter
- a Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany
| | - Lars Ostergaard
- b Department of Infectious Diseases , Aarhus University Hospital , Aarhus , Denmark
| | - Ole S Søgaard
- b Department of Infectious Diseases , Aarhus University Hospital , Aarhus , Denmark
| | - Martin Tolstrup
- b Department of Infectious Diseases , Aarhus University Hospital , Aarhus , Denmark
| | - Andreas M Kaufmann
- a Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany
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