239例传统巴氏涂片阳性结果与宫颈活检病理结果的对比分析

目的通过对239例传统巴氏涂片阳性病例的细胞学结果与其宫颈活检的病理学结果对比分析,探讨传统巴氏涂片对筛查宫颈癌前病变及宫颈癌的有效性。方法用传统巴氏刮板刮取宫颈脱落细胞进行细胞学检查,细胞学阳性的病例再进行阴道镜检查,并取多点活检。结果239例病人的活检病理诊断结果为:炎症123例(51.46%);CINⅠ43例(17.99%);CINⅡ25例(10.46%);CINⅢ41例(17.15%,其中CIS7例);浸润癌7例(2.93%)。结论传统巴氏涂片能早期发现CIN尤其是CINⅡ以上病变,是早期宫颈病变筛查的有效方法。     

宜宾县农村妇女宫颈癌筛查结果分析

目的早期发现、早期诊断、及时治疗宫颈癌和癌前病变。方法首先对妇女进行妇科检查和宫颈刮片细胞学检查(巴氏涂片),其次针对TBS分级异常的妇女,进行阴道镜检查,然后对宫颈及宫颈管病灶处或可疑病变区行活组织检查,最后进行统计学分析。结果宫颈刮片细胞学检查异常率为受检人数的4.12%,醋酸染色和碘染色配合阴道镜检查异常数占宫颈刮片细胞学异常者的24.5%,醋酸染色和碘染色配合阴道镜检查异常者活组织检查全部异常。结论宫颈刮片细胞学检查操作简便,成本低廉,是宫颈癌筛查的主要方法,结合阴道镜检查及宫颈和宫颈管活组织检查的方法进行宫颈癌筛查,诊断准确率更高,值得在贫困地区的宫颈癌筛查工作中去运用和推广。     

化学与生活

食用红色素对人体无害几年前,食用红色素会致癌的可怕说法使美国各地的消费者不寒而栗。现在有人发现,食用红色素的作用恰恰相反。美国伊利诺斯大学的研究人员发现,在西红柿、辣椒和西瓜中都含有的红色素也许能抗癌。他们测量了100多名患有早期宫颈癌的妇女的血液类红叶     

宫颈癌三级预防

本文主要根据目前宫颈癌发病率较高,有年轻化趋势,严重威胁妇女身体健康状况,从病因学预防、早发现、早诊断、早治疗,术后康复3个层面阐述宫颈癌防治原则及方法。预防为主,群防群治,防治结合,调动工作人员及工作对象的积极性,形成合力,从而降低宫颈癌发病率,确保广大妇女身体健康和生命安全。     

宫颈癌三级预防

本文主要根据目前宫颈癌发病率较高,有年轻化趋势,严重威胁妇女身体健康状况,从病因学预防、早发现、早诊断、早治疗,术后康复三个层面阐述宫颈癌防治原则及方法。预防为主,群防群治,防治结合,调动工作人员及工作对象的积极性,形成合力,从而降低宫颈癌发病率,确保广大妇女身体健康和生命安全。     

宫颈癌三级预防

本文主要根据目前宫颈癌发病率较高,有年轻化趋势,严重威胁妇女身体健康状况,从病因学预防、早发现、早诊断、早治疗,术后康复三个层面阐述宫颈癌防治原则及方法。预防为主,群防群治,防治结合,调动工作人员及工作对象的积极性,形成合力,从而降低宫颈癌发病率,确保广大妇女身体健康和生命安全。     

HPV-DNA检测在宫颈癌筛查中的应用

目的探讨高危型人乳头状瘤病毒(HR-HPV)检测在宫颈病变筛查中的作用。方法320例病人行第二代杂交捕获(HC-II)法检测HPV-DNA和宫颈活检组织学检查,以病理组织学诊断为金标准,分析感染与宫颈癌及宫颈上皮内瘤变的关系。结果HPV-DNA高危型阳性组CIN发病率明显高于阴性组(P<0.01);HPV-DNA高危型阳性组宫颈病变程度明显高于阴性组(P<0.05)。结论女性生殖道高危型HPV感染是宫颈癌及CIN流行的主要危险因素,提示宫颈癌的防治应重点预防HPV感染。     

人乳头瘤病毒疫苗的研究进展

宫颈癌是全球妇女恶性肿瘤中仅次于乳腺癌的第二种最常见的恶性肿瘤。人乳头瘤病毒(Human papillo-mavirus,HPV)与宫颈癌的发生密切相关,利用分子生物学方法构建的HPV疫苗对宫颈癌具有预防和治疗作用。目前,HPV疫苗的研究得到了迅速发展,并涌现出许多新的开发策略。本文对HPV疫苗的研究进展和前景作一综述。     

电子阴道镜在宫颈疾病中的诊断价值

目的探讨电子阴道镜在宫颈疾病诊断中的价值、临床意义及应用体会。方法收集我院2005年1月至2007年12月妇产科260例宫颈疾病患者,进行阴道镜检查并行宫颈活检组织学检查。进行回顾性分析,比较和总结。结果电子阴道镜在诊断宫颈病变中敏感度为86.21%,特异度为89.22%,假阴性率(漏诊率)2.7%,阳性预测值为91.76%。阴道镜图像与组织学结果相比:醋白上皮符合率为65.38%,二联征符合率为71.43%,三联征符合率和可疑宫颈癌符合率为82.35%。结论电子阴道镜检查技术诊断宫颈疾病结果准确可靠,有一定的应用价值,特别对CIN的早期诊断,早期治疗及降低宫颈癌的发生率有重要的指导意义。     

TCT筛查、阴道镜活检及病理在宫颈癌筛查中的应用

目的评价TCT宫颈液基细胞学、阴道镜下活检及组织病理学在宫颈癌筛查中的作用。方法回顾性分析TCT筛查异常的397例患者,包括非典型鳞状上皮细胞(ASC)195例,低度鳞状上皮内瘤变(LSIL)82例,高度鳞状上皮内瘤变(HSIL)114例,均行阴道镜下活检进行病理诊断。结果宫颈上皮内瘤变(CIN)CINⅠ43例、CINⅡ39例、CINⅢ45例、HPV感染14例、慢性宫颈炎168例、宫颈原位癌及宫颈浸润癌共27例。CIN及原位癌年龄主要分布在26～45岁,宫颈浸润癌主要分布在36～45岁,TCT对LSIL、HSIL和宫颈浸润癌的诊断符合率为20.73%、62.28%、100%。同时,53.66%的LSIL和37.72%的HSIL被细胞学诊断过高,25.61%的LSIL被细胞学诊断过低。结论宫颈癌筛查十分必要,TCT筛查、阴道镜活检及病理三阶梯检查对宫颈癌可以进行早诊断、早治疗,从而降低宫颈浸润癌的死亡率。     

Multistep Model of Cervical Cancer: Participation of miRNAs and Coding Genes

Aberrant miRNA expression is well recognized as an important step in the development of cancer. Close to 70 microRNAs (miRNAs) have been implicated in cervical cancer up to now, nevertheless it is unknown if aberrant miRNA expression causes the onset of cervical cancer. One of the best ways to address this issue is through a multistep model of carcinogenesis. In the progression of cervical cancer there are three well-established steps to reach cancer that we used in the model proposed here. The first step of the model comprises the gene changes that occur in normal cells to be transformed into immortal cells (CIN 1), the second comprises immortal cell changes to tumorigenic cells (CIN 2), the third step includes cell changes to increase tumorigenic capacity (CIN 3), and the final step covers tumorigenic changes to carcinogenic cells. Altered miRNAs and their target genes are located in each one of the four steps of the multistep model of carcinogenesis. miRNA expression has shown discrepancies in different works; therefore, in this model we include miRNAs recording similar results in at least two studies. The present model is a useful insight into studying potential prognostic, diagnostic, and therapeutic miRNAs.     

运用实时荧光定量RT-PCR检测人正常组织及肿瘤组织中BRDT表达

目的探讨BRDT基因在正常组织及癌组织中的分布及其作为肿瘤治疗靶分子的可能性。方法运用实时荧光定量PCR方法分析BRDT在人正常组织及癌组织中的表达,使用18S rRNA作为内对照。结果在所检测的正常组织中该蛋白的mRNA只存在于睾丸组织中,而在其它组织不表达;在检测的10例胃腺癌组织标本中,有6例mRNA的微弱表达;在检测的10例食管鳞状细胞癌组织标本中,有3例mRNA的微弱表达;在检测的12例子宫颈鳞状细胞癌组织标本中均未有表达;在检测9例子宫内膜腺癌组织标本中,有2例微弱表达;在检测12例脑癌组织标本中,只有1例微弱表达。结论BRDT不可能作为子宫颈鳞状细胞癌、脑癌、子宫内膜腺癌及食管鳞状细胞癌治疗的潜在分子靶点,是否能够做胃腺癌的靶点还需进一步探讨。     

Smac和MDM2蛋白在子宫颈鳞状细胞癌中的表达及意义

目的探讨Smac和MDM2蛋白的表达与宫颈鳞癌临床病理参数之间的关系,以了解其在宫颈癌的发生、发展、转移中的作用及意义。方法用免疫组织化学方法,检测60例宫颈鳞癌和45例宫颈上皮内瘤变(CIN)及15例正常宫颈组织中smac和MDM2蛋白的表达,并分析其表达与年龄、肿瘤大小、组织学分级及淋巴结转移间的关系。结果Smac蛋白在正常宫颈、低级别宫颈上皮内瘤变(CINⅠ)、高级别宫颈上皮内瘤变(CINⅡ-Ⅲ)及宫颈鳞癌组织中的阳性表达率分别为100%(15/15)、85%(17/20)、72%(18/25)及65%(39/60)。MDM2蛋白在正常宫颈、子宫颈低、高级别鳞状上皮内瘤变及宫颈鳞癌中的阳性表达率分别为0(0/15)、10%(2/20)、22.4%(6/25)及61.7%(37/60);Smac和MDM2蛋白的表达在正常宫颈对照组和CINII-III及与宫颈鳞癌之间均有统计学差异(P<0.05)。宫颈鳞癌中Smac和MDM2蛋白表达在淋巴结有无转移及组织分化分组中,差异有统计学意义(P<0.05);Smac蛋白和MDM2蛋白的表达之间存在负相关性(r=-0.435,P<0.001)。结论Smac和MDM2...     

Helper T Lymphocyte Response in the Peripheral Blood of Patients with Intraepithelial Neoplasia Submitted to Immunotherapy with Pegylated Interferon-α

Immunotherapy in cancer patients is a very promising treatment and the development of new protocols and the study of the mechanisms of regression is imperative. The objective of this study was to evaluate the production of cytokines in helper T (CD4⁺) lymphocytes during immunotherapy with pegylated IFN-α in patients with cervical intraepithelial neoplasia (CIN). We conducted a prospective study with 17 patients with CIN II-III using immunotherapy with pegylated IFN-α subcutaneouly weekly, and using flow cytometry we evaluated the peripheric CD4⁺ T lymphocytes. The results show that in the regression group the patients presented a significant increase in the amount of IFN-γ during the entire immunotherapy, compared with the group without a response. The amount of CD4⁺ T lymphocytes positive for IL-2, IL-4, IL-10 and TGF-β is significantly lower in patients with good clinical response. The results also demonstrate that patients with regression have a higher amount of intracellular TNF-α in CD4⁺ T lymphocytes before the start of treatment. Analyzing these data sets, it can be concluded that immunotherapy is a viable clinical treatment for patients with high-grade CIN and that the regression is dependent on the change in the immune response to a Th1 pattern.     

实时荧光定量PCR方法检测人癌组织中RFP蛋白的表达

目的检测RFP(Ret finger protein)蛋白在人正常组织及人癌组织中的分布。方法采用实时荧光定量PCR方法,以18 S rRNA为内对照,检测RFP在人正常组织及人癌组织中的表达水平。结果RFP表达水平子宫颈鳞状细胞癌组织高于正常子宫颈组织,子宫内膜腺癌组织高于正常子宫内膜组织,胃腺癌组织高于正常胃组织,食管鳞状细胞癌组织高于正常食管组织,而子宫内膜腺癌组织高于子宫颈鳞状细胞癌组织,胃腺癌组织高于食管鳞状细胞癌组织,脑癌组织高于正常脑组织。结论RFP可能成为治疗恶性肿瘤的一个潜在的分子靶点。     

Bazedoxifene,a GP130 Inhibitor,Modulates EMT Signaling and Exhibits Antitumor Effects in HPV-Positive Cervical Cancer

Persistent HPV (Human Papillomavirus) infection is the primary cause of cervical cancer. Despite the development of the HPV vaccine to prevent infections, cervical cancer is still a fatal malignant tumor and metastatic disease, and it is often difficult to treat, so a new treatment strategy is needed. The FDA-approved drug Bazedoxifene is a novel inhibitor of protein–protein interactions between IL-6 and GP130. Multiple ligand simultaneous docking and drug repositioning approaches have demonstrated that an IL-6/GP130 inhibitor can act as a selective estrogen modulator. However, the molecular basis for GP130 activation in cervical cancer remains unclear. In this study, we investigated the anticancer properties of Bazedoxifene in HPV-positive cervical cancer cells. In vitro and in vivo experiments showed that Bazedoxifene inhibited cell invasion, migration, colony formation, and tumor growth in cervical cancer cells. We also confirmed that Bazedoxifene inhibits the GP130/STAT3 pathway and suppresses the EMT (Epithelial-mesenchymal transition) sub-signal. Thus, these data not only suggest a molecular mechanism by which the GP130/STAT3 pathway may promote cancer, but also may provide a basis for cervical cancer replacement therapy.     

Evaluating the role of human papillomavirus vaccine in cervical cancer prevention

Persistent genital infection with human papillomavirus (HPV) is a natural candidate as a surrogate marker for cervical cancer because of the strong epidemiologic and molecular evidence that HPV infection is the causative agent for almost all cervical cancers. However, while infection with high-risk types of HPV appears to be necessary for the development of cervical cancer, most infections are controlled by host immune response and do not lead to cancer in the vast majority of infected women. Because diagnostic tests cannot distinguish a persistent infection in the pathogenesis of cervical cancer from a transient infection, it is difficult to describe the disease mechanism as a progressive process based on observations. Therefore, the disease pathogenesis pathway does not fit into the usual surrogate marker framework, raising practical concerns about using HPV infection as a surrogate for a clinical endpoint in vaccine trials. In this paper, we describe the challenges in defining HPV infection as a surrogate endpoint in a HPV vaccine trial that is aimed at reducing cervical cancer rates and examine potential effects of the vaccine. We then outline some issues in the design and analysis of HPV vaccine trials, including the use of operationally defined HPV infection events meant to capture persistent infections. We conclude with a recommendation for a multistate model that uses HPV infection to help explain the mechanisms of vaccine action rather than validate it as an endpoint substitute.     

Leep治疗宫颈上皮内瘤变128例临床分析

目的探讨高频电波刀(Leep)治疗宫颈上皮内瘤变的临床价值。方法对经阴道镜下宫颈活检诊断为宫颈上皮内瘤变(CIN)的128例患者采用Leep宫颈锥切,观察手术时间、出血量,比较术前宫颈活检与术后病理结果,随诊疗效和宫颈塑形情况结果。结果Leep术治疗宫颈上皮内瘤变平均时间6.5min,出血量10.2mL,阴道镜下宫颈活检的宫颈上皮内瘤变(CIN)的CINⅠ,CINⅡ,CINⅢ,与Leep术后标本的病理诊断CINⅠ,CINⅡ,CINⅢ呈正相关关系(rs=0.74,P<0.01),125例宫颈塑形满意113例(90.4%)。结论Leep切除宫颈上皮内瘤变具有手术时间短,术中出血少,并发症少,切除物可送病检,操作简单,安全有效,经济适用等特点,患者易接受,在妇产科临床工作中值得推广。