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Background: Persistent HR-HPV causes cervical cancer, exhibiting geographic variance. Europe/Americas have higher HPV16/18 rates, while Asia/Africa predominantly have non-16/18 HR-HPV. This study in Fujian, Asia, explores non-16/18 HR-HPV infections, assessing their epidemiology and cervical lesion association for targeted prevention. Methods: A total of 101,621 women undergoing HPV screening at a hospital in Fujian Province from 2013 to 2019 were included. HPV genotyping was performed. A subset of 11,666 HPV-positive women with available histopathology results were analyzed to characterize HPV genotype distribution across cervical diagnoses. Results: In 101,621 samples, 24.5% tested positive for HPV. Among these samples, 17.3% exhibited single infections, while 7.2% showed evidence of multiple infections. The predominant non-16/18 high-risk HPV types identified were HPV 52, 58, 53, 51, and 81. Single HPV infections accounted for 64.1% of all HPV-positive cases, with 71.4% of these being non-16/18 high-risk HPV infections. Age-related variations were observed in 11,666 HPV-positive patients with pathological results. Cancer patients were older. In the cancer group, HPV52 (21.8%) and HPV58 (18.6%) were the predominant types, followed by HPV33, HPV31, and HPV53. Compared to single HPV16/18 infection, non-16/18 HPV predominated in LSIL. Adjusted odds ratios (OR) for LSIL were elevated: multiple HPV16/18 (OR 2.18), multiple non-16/18 HR-HPV (OR 2.53), and multiple LR-HPV (OR 2.38). Notably, solitary HPV16/18 conferred higher odds for HSIL and cancer. Conclusion: Our large-scale analysis in Fujian Province highlights HPV 52, 58, 53, 51, and 81 as predominant non-16/18 HR-HPV types. Multiple HPV poses increased LSIL risks, while solitary HPV16/18 elevates HSIL and cancer odds. These findings stress tailored cervical cancer prevention, highlighting specific HPV impacts on lesion severity and guiding region-specific strategies for optimal screening in Asia, emphasizing ongoing surveillance in the vaccination era.
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Genótipo , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Humanos , Feminino , Infecções por Papillomavirus/virologia , Pessoa de Meia-Idade , Adulto , China/epidemiologia , Neoplasias do Colo do Útero/virologia , Neoplasias do Colo do Útero/prevenção & controle , Papillomaviridae/genética , Papillomaviridae/isolamento & purificação , Idoso , Detecção Precoce de Câncer , Papillomavirus Humano 18/genética , Papillomavirus Humano 18/isolamento & purificaçãoRESUMO
Objective: Investigate HPV types in cervical specimens, their correlation with p16 expression in lesions, and diagnostic value for cervical lesions. Enhance clinical diagnosis reliability. Methods: Retrospective cross-sectional study at Fujian Maternity and Child Health Hospital's Cervical Disease Center (Jun 2019-Dec 2021). Patients with abnormal cervical screening underwent colposcopy and conization. Pathological diagnosis based on colposcopy, cervical biopsy, ECC, and conization. Analyzed HPV genotyping (18 HR-HPV, 5 LR-HPV) and p16 expression correlation. Statistical analysis used R software. Results: he expression of p16 is significantly associated with the infection of high-risk HPV types, such as 16, 33, 52, and 58, with an increased risk of 1.4 times or higher (OR=1.91, 3.14, 1.40, and 1.78, respectively). The risk of p16 expression increased 4-fold for multiple high-risk HPV types [adjusted OR (95% CI) = 4 (2.92~5.5), P-value <0.001]. Compared to the p16(-) group, the p16(+) group had a higher association with cervical lesions worse than HSIL (High-grade Squamous Intraepithelial Lesions).In the group with multiple Human Papillomavirus Infections with types 16, 33, 52, and 58, the risk of cervical lesions worse than HSIL increased by up to 660-fold compared to the negative group (adjusted OR=660.62, 95% CI: 91.39~4775.53, P<0.001), indicating that this combination of HPV types posed the greatest risk for cervical lesions above HSIL. Conclusions: p16 plays a crucial role in cervical lesion progression, linked to high-risk HPV. Combining p16 with HPV screening improves cervical cancer detection. Studying multiple HPV infections will enhance prevention and management.
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Aims: Abnormal vessel patterns are specific signs in patients with early cervical abnormality and cervical cancer(CC) by colposcopy, but the impact of human papillomavirus (HPV) infections on abnormal vessel patterns remains unknown. Methods: A total of 6716 female patients with HPV infections or cytological abnormalities who underwent a colposcopy following abnormal CC screening results were included in the study. The final pathological diagnosis was confirmed to be the most severe pathological grade across cervical biopsy, endocervical canal curettage (ECC) and conization. Univariate and multivariate logistic regression analyses were used to investigate the association between HPV infections and abnormal vessel patterns, adjusting for age, gravidity and parity. Results: There were 6124 normal vascular cases by colposcopy and 592 cases with cervical vascular abnormality. The prevalence of HPV infections was 4284 (70%) in normal patients, and the prevalence of HPV infections was 479 (80%) in cervical vascular abnormality patients. HPV high-risk type 16 infection alone increased the risk of cervical heteromorphic blood vessels (aOR=3.66, 95%CI: 2.54~5.27). HPV 16 and 33 alone (other than the commonly recognized subtype of 18) or coinfection of these two genotypes could increase the risk of cervical punctate vascular and cervical vascular mosaic features and abnormal cervical blood vessels. An increased risk of abnormal cervical lesions was observed for HPV 16 and 33 alone or combined in coinfection compared to the negative group. The risk of cervical vascular abnormality was increased 10-fold by coinfection with HPV 16 and 33 (aOR=10.67, 95% CI: 4.54~25.09, P<0.001). HPV 16, 33 alone or combined in coinfection were associated with an increased risk of lesions more advanced than high-grade squamous intraepithelial lesion (HSIL) when compared to the negative group. The risk of lesions more advanced than HSIL was up to 26-fold higher in the coinfection with HPV 16 and 33 group than in the negative group (aOR=26.23, 95%CI: 11.23~61.27, P<0.001). Conclusion: HPV16 and 33 are the most dangerous HPV genotypes correlated with abnormal vascular patterns. Combined HPV16 and HPV33 infection increases the risk of abnormal vascular patterns. Combined HPV16 and HPV33 infection increases the risk of developing HSIL+.
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RIPK4 has been implicated in multiple cancer types, but its role in ovarian cancer (OC) has not been clearly elucidated. Our data from Gene Expression Profiling Interactive Analysis, RT-PCR, and immunohistochemical analysis showed that RIPK4 was expressed at higher levels in OC tissues and cells than in normal ovarian tissues and cells. Increased RIPK4 expression in OC markedly correlated with a worse overall survival than lower RIPK4 expression levels (hazard rate (HR) 1.5 (1.45-1.87); P = 0.001). In functional experiments, RIPK4 downregulation significantly inhibited metastatic behaviours in OC cells. Subsequently, based on data from 593 OC patients in the TCGA database, gene set enrichment analysis revealed that RIPK4 was involved in epithelial-mesenchymal transition (EMT) in OC. At the molecular level, silencing RIPK4 significantly downregulated vimentin, N-cadherin, and Twist expression but induced an increase in the protein level of E-cadherin and inhibited the IL-6 and STAT3 levels. Moreover, IL-6 levels were significantly decreased in RIPK4-silenced OC cells (P < 0.05). The addition of IL-6 to OC cells rescued the suppressive effect of RIPK4 knockdown on EMT. Thus, our data illustrate that downregulation of RIPK4 expression can restrain EMT in OC by inhibiting IL-6. This finding may provide a novel diagnostic and therapeutic target for improving the poor prognoses of OC patients.
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Carcinoma Epitelial do Ovário/imunologia , Transição Epitelial-Mesenquimal/imunologia , Interleucina-6/metabolismo , Neoplasias Ovarianas/imunologia , Proteínas Serina-Treonina Quinases/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Epitelial do Ovário/genética , Carcinoma Epitelial do Ovário/mortalidade , Carcinoma Epitelial do Ovário/patologia , Linhagem Celular Tumoral , Biologia Computacional , Feminino , Regulação Neoplásica da Expressão Gênica/imunologia , Técnicas de Silenciamento de Genes , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Proteínas Serina-Treonina Quinases/genética , Regulação para Cima/imunologia , Adulto JovemRESUMO
OBJECTIVE: The aim of this study was to discuss the clinical characteristics and the prognosis of surgically diagnosed endometriosis complicated by endometrial polyps and investigate the association between pregnancy outcomes during subsequent pregnancies. MATERIALS AND METHODS: From January 2013 to December 2016, 1263 infertile patients were enrolled in the study. We identified 451 patients with endometriosis, and divided them into a polyp group (n = 204) and a non-polyp group (n = 247) based on whether or not they were associated with endometrial polyps. Postoperative clinical pregnant women (n = 82) among the polyp group were then classified into a study group and a control group composed of those undergoing a singleton pregnancy (n = 164) who delivered during the same time period. Clinical statuses and complications during pregnancy and delivery were collected from hospitals and by telephone interviews and surveys through the mail. RESULTS: The prevalence rate of endometriosis infertile group was obviously higher than the non-endometriosis infertile group ([45.23%; 204/451] versus [17.12%; 139/812]). Women suffering from stage 1 to 4 endometriosis had a 42.44% (73/172), 40.69% (59/145), 55.89% (38/68) and 51.52% (34/66) occurrence rate of endometrial polyps, respectively. The frequency of endometrial polyps for stage 3 and 4 patients was obviously higher than that of stage 1 and 2 patients ([53.73%; 72/134] versus [41.64%; 132/317]). Moreover, the occurrence rate of deep infiltrating endometriosis (DIE) was 57.81% (37/64), which was obviously higher than that of ovarian endometriosis (42.42%; 98/231) and peritoneal endometriosis (44.23%; 69/156). Of the 204 women diagnosed with posterior endometrial polyps, 89 became pregnant, 7 pregnancies ended in a spontaneous abortion, and 82 successfully delivered a baby. The clinical pregnancy rate of patients in stages 1 and 2 was wholly higher than that of patients in stages 3 and 4 ([48.70%; 56/115] versus [37.71%; 26/82]). The postsurgical pregnancy status of patients suffering from peritoneal endometriosis was slightly better than those with ovarian or DIE, but differences were not statistically significant (P = 0.626). We also found that the pregnancy rate was statistically elevated in patients whose EFI scores range from 7 to 10. When compared to the control group, women with endometriosis and endometrial polyps had a higher risk of their pregnancy being complicated by placenta previa (13.41%) and cesarean delivery (59.76%). CONCLUSION: Patients with endometriosis have a higher frequency of endometrial polyps. We found that a combined hysteroscopy and laparoscopy surgical procedure is an effective way to increase pregnancy rates. Different endometriosis stages and types in patients were associated with clinical pregnancy and spontaneous abortion rates. Women affected by both endometriosis and endometrial polyps have an independently elevated risk of placenta previa and cesarean delivery during pregnancy.
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Endometriose/epidemiologia , Infertilidade Feminina/complicações , Pólipos/epidemiologia , Resultado da Gravidez/epidemiologia , Doenças Uterinas/epidemiologia , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/etiologia , Adulto , Cesárea/estatística & dados numéricos , Endometriose/etiologia , Endometriose/cirurgia , Feminino , Humanos , Histeroscopia/métodos , Laparoscopia/métodos , Placenta Prévia/epidemiologia , Placenta Prévia/etiologia , Pólipos/etiologia , Pólipos/cirurgia , Gravidez , Taxa de Gravidez , Prevalência , Estudos Retrospectivos , Doenças Uterinas/etiologia , Doenças Uterinas/cirurgiaRESUMO
OBJECTIVE: This study aimed to evaluate the reproductive outcomes of patients who underwent hysteroscopic metroplasty for correction of a complete septate uterus. METHODS: The study population comprised 92 women with complete septate uteri. Hysteroscopic metroplasty and laparoscopy were performed simultaneously in these patients. The postoperative reproductive outcome of each patient was evaluated. RESULTS: In the primary infertility group, there were 32 (40%) pregnancies. In the abortion group, the number of miscarriages decreased from 68 (94.44%) to 5 (10.42%), while the number of live births increased from 1 (1.39%) to 42 (87.50%) after resection compared with before resection. The cumulative probability of pregnancy and that of live-birth pregnancy in the abortion group were significantly higher than those in the primary infertility group after surgery. Furthermore, resection of the cervical septum resulted in a significantly higher cumulative probability of live birth compared with preservation of the cervical septum. CONCLUSION: Hysteroscopic uterine metroplasty may improve the reproductive performance of a septate uterus. Resection of the cervical septum may increase the probability of a live-birth pregnancy for patients with a cervical septum, and this procedure could be recommended for cases of a complete uterine septum.
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Aborto Espontâneo , Histeroscopia , Infertilidade Feminina , Útero , Colo do Útero/cirurgia , Feminino , Humanos , Infertilidade Feminina/etiologia , Infertilidade Feminina/cirurgia , Nascido Vivo , Gravidez , Resultado da Gravidez , Útero/anormalidades , Útero/cirurgiaRESUMO
STUDY OBJECTIVE: This study characterizes the etiology, clinical features and outcomes of prepubescent vaginal bleeding and summarizes our experience. DESIGN: The data of patients who were hospitalized with vaginal discharge or bleeding treated from January 2012 to December 2018 were retrospectively reviewed. SETTING: A provincial Grade III Level A Maternity and Children's Hospital. PARTICIPANTS: Prepubertal patients with vaginal discharge or bleeding. MAIN OUTCOME MEASURES: Patient age, bleeding duration, etiology, treatment and prognosis were recorded. Physical examinations and color Doppler ultrasonography were also performed. RESULTS: There were 158 patients aged from 1 month to 10 years (mean age 5.2 years). Bleeding duration ranged from 1 to 98 days, with an average of 13.3 days. Sixty patients were diagnosed with vaginal foreign bodies, 34 with vulvovaginitis, 34 with vulvar trauma, 13 with ovarian granulosa cell tumors, 8 with urethral mucosa prolapse, 5 with vaginal yolk sac tumors and 1 each with pituitary tumor, hypothyroidism, McCune-Albright syndrome, and short-term intake of a large number of strawberries. All the children were treated according to their different disease etiologies. CONCLUSION: Prepubertal vaginal bleeding is caused by a variety of different conditions. In our study, the most common causes were vaginal foreign bodies, vulvovaginitis, trauma, vaginal malignant tumors and urethral mucosa prolapse. Careful medical histories and targeted examinations are needed. Vaginoscopy could be considered. Considering the different causes, different treatments should be administered to achieve a good prognosis.
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Hemorragia Uterina/etiologia , Descarga Vaginal/etiologia , Criança , Pré-Escolar , China , Feminino , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Exame Ginecológico , Humanos , Lactente , Estudos Retrospectivos , Doenças Uretrais/complicações , Doenças Uretrais/diagnóstico , Neoplasias Vaginais/complicações , Neoplasias Vaginais/diagnóstico , Vulvovaginite/complicações , Vulvovaginite/diagnósticoRESUMO
Epithelial ovarian cancer is the most lethal gynecological malignancies for readily metastasis. Exosomes have played an influential role in carcinogenicity and cancer progression. Our aim is to discover exosome-related mechanisms in ovarian cancer progress and explore potential diagnostic biomarkers and therapeutic targets of ovarian cancer. We initially presented the proteomic profiles of exosomes derived from two late-stage ovarian cell lines, OVCA429 and HO8910PM. A total of 2940 exosomal proteins were recorded by MS. FunRich appropriately processed these exosomal proteins, manifesting some superiority in contrast to Blast2go. Moreover, we demonstrated the pentose phosphate pathway was a dominant mechanism in exosome mediated intracellular communication. Glucose-6-phosphate dehydrogenase, transketolase and transaldolase 1, three key enzymes regulated pentose phosphate pathway, were all marked in the same exosomal parts of proteins between two ovarian cell lines. Moreover, these key proteins might become diagnostic, prognostic biomarkers and therapeutic targets of ovarian cancer.
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Biomarcadores Tumorais/metabolismo , Enzimas/metabolismo , Exossomos/enzimologia , Neoplasias Epiteliais e Glandulares/enzimologia , Neoplasias Ovarianas/enzimologia , Via de Pentose Fosfato , Proteômica/métodos , Carcinoma Epitelial do Ovário , Linhagem Celular Tumoral , Exossomos/patologia , Feminino , Glucosefosfato Desidrogenase/metabolismo , Humanos , Espectrometria de Massas , Estadiamento de Neoplasias , Neoplasias Epiteliais e Glandulares/secundário , Neoplasias Ovarianas/patologia , Transaldolase/metabolismo , Transcetolase/metabolismoRESUMO
OBJECTIVE: To study the effect of urodynamic factors on the urinary retention of the patients with cervical cancer received radical hysterectomy. METHODS: Seventy-two patients with cervical cancer International Federation of Gynecology and Obstetrics (FIGO) stage Ib1 to IIa hospitalized in Fujian Provincial Maternity and Child Health Hospital between June 2006 and August 2009, who were not found any abnormal representation of urodynamics before the operation, were divided into the group with urinary retention and the group without urinary retention based on whether urinary retention after the operation. All patients were detected by urodynamic examination following radical hysterectomy. Data obtained from urodynamic examination were analysed by logistic regression to evaluate the influence of urodynamic factors on the urinary retention postoperation. RESULTS: Twenty-one patients out of all were found with urinary retention after the operation, the incidence rate of urinary retention was 29%. The first sensation after operation in both groups were increased significantly than those before operation [(171 ± 61) ml vs. (126 ± 28) ml, (134 ± 39) ml vs. (119 ± 17) ml, all P < 0.05], while the maximum volume [(337 ± 66) and (300 ± 66) ml, respectively], the compliance [(31 ± 25) and (29 ± 18) ml/cm H2O (1 cm H2O = 0.098 kPa), respectively], the maximum flow rate [(10 ± 4) and (12 ± 5) ml/s, respectively] and the pressure at the maximum flow rate [(27 ± 9) and (32 ± 8) cm H2O, respectively] were decreased obviously after radical hysterectomy in both the group with urinary retention and the group without urinary retention (all P < 0.05), compared with the corresponding value before the operation. The urodynamic changes in urinary retention group was much more severe than those in group without urinary retention (P < 0.05). The single factor analysis results showed that bladder destusor dysfunction (OR = 8.20, 95%CI: 2.62-25.66, P < 0.01) and lack of sensation (OR = 6.90, 95%CI: 1.95-24.43, P < 0.01) were relevant to the urinary retention post-operation. While there were not relationship was found between low compliance bladder (OR = 1.99, 95%CI: 0.70-5.63, P = 0.195), detrusor overactivity (OR = 2.51, 95%CI: 0.73-8.67, P = 0.144), bladder outlet obstruction (OR = 3.77, 95%CI: 0.76-18.57, P = 0.104) or dyssynergia of urethral external sphincter (OR = 2.67, 95%CI: 0.49-14.45, P = 0.255) and urinary retention following the operation. There were an antagonistic effects (OR = 7.60, 95%CI: 1.43-40.39, P = 0.017) of detrusor overactivity and bladder destrusor dysfunction on urinary retention. The multiple factors analysis results revealed that bladder destusor dysfunction (OR = 7.01, P < 0.01) and lack of sensation (OR = 5.45, P = 0.018)were the independent risk factors influencing on the urinary retention post-operation. CONCLUSIONS: There are obvious urodynamic change in cervical cancer patients following radical hysterectomy. Bladder destrusor dysfunction and lack of sensation are the independent urodynamic risk factors influencing on urinary retention following radical hysterectomy, while detrusor over activity may be a protective effect on bladder destrusor dysfunction post-operation in some degree. Urodynamic test is important for analysis and treatment of urinary retention following radical hysterectomy.