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1.
BMC Infect Dis ; 21(1): 504, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34058992

RESUMO

BACKGROUND: HPV self-sampling has been widely supported by the scientific community following a strong body of literature on the subject. Self-sampling is important in cervical cancer screening as it has been shown to improve participation. It is well documented that HPV-testing has proven superior to cytology with regards to sensitivity in detection of CIN and cancer. The value of self-collected samples is reliant on the quality of the molecular testing performed, as well as the patients' preference in sampling procedure and compliance to follow up on positive test results. Due to the incompatibility of self-samples and cytology, triage of HPV-DNA positives by testing for molecular biomarkers is highly warranted. METHODS: Our objective was to compare the detection rate of genital Human Papillomavirus (HPV) infection in self- and clinician-collected samples by a 14-type HPV-DNA test and a 7-type mRNA E6/E7 test. RESULTS: Five hundred five women were recruited. Each study participant had two sample collection procedures performed upon the same visit, alternating order in execution of the self-collection or the clinician-taken procedure first or second, 1010 samples in total. HPV-DNA prevalence was 22.8% in self-collected versus 19.2% in clinician-collected samples (P = 0.19). Overexpression of mRNA E6/E7 from 7 HPV types was 7.1 and 6.3%, respectively (P = 0.71). The difference between HPV-DNA and HPV-mRNA positivity rates were statistically significant in both self-collected (22.8% versus 7.1%, P < 0.001) and clinician-collected samples (19.2% versus 6.3%, P < 0.001). Overall agreement between the two collection methods was fair, with a concordance rate of 78.2% (390/505), k = 0.34 (95% CI: 0.25-0.44), P < 0.001, for the HPV-DNA test and 92.5% (467/505), k = 0.40 (95% CI, 0.25-0.56), P < 0.001, for the mRNA test, respectively. 96.8% of the participants reported they felt confident carrying out the self-collection themselves, and 88.8% reported no discomfort at all performing the procedure. CONCLUSIONS: This comparative study of two sampling methods reports fair agreement of HPV positivity rates between the self-collected and clinician-collected specimens using Abbott hrHPV and PreTect HPV-Proofer'7 tests. Only one third of HPV-DNA positive women had overexpression of mRNA E6/E7. TRIAL REGISTRATION: ISRCTN77337300 .


Assuntos
Técnicas de Diagnóstico Molecular/métodos , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Manejo de Espécimes/métodos , Adulto , DNA Viral/genética , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Papillomaviridae/genética , RNA Mensageiro/genética , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/virologia
2.
Afr J Reprod Health ; 25(1): 161-168, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34077121

RESUMO

Primary vaginal leiomyosarcoma is a rare gynecological malignancy. The clinical presentation is a benign looking well circumscribed mobile mass which might however occasionally present with distant metastases. Post treatment recurrence is common, and the clinical course is often unpredictable. Primary surgical management plus radiotherapy is the commonly practiced treatment of choice. We report a case of primary vaginal epithelioid leiomyosarcoma that recurred twice after local surgical resection. The patient subsequently underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a recurrent vaginal leiomyosarcoma. Histopathology of the vaginal mass revealed an epithelioid leiomyosarcoma of the vagina. She also received a course of adjuvant radiotherapy. The patient was free of recurrence at 3 year follow up. Vaginal mass must be evaluated with a high index of suspicion for malignancy. Local surgical resection alone is insufficient for primary vaginal leiomyosarcoma. Surgical resection with adjuvant radiotherapy offers better treatment outcomes with decreased risk of recurrence. Empirical oophorectomy in patients with completed family size might confer additional benefit in preventing disease recurrence in resource limited settings where testing for estrogen and progesterone receptor status of the tumour is unavailable. Due to the unpredictable course of the disease, lifelong patient follow-up is critical for better outcomes.


Assuntos
Histerectomia/métodos , Leiomioma/cirurgia , Leiomiossarcoma/terapia , Radioterapia Adjuvante/efeitos adversos , Salpingo-Ooforectomia/métodos , Neoplasias Vaginais/cirurgia , Botsuana , Feminino , Humanos , Leiomioma/patologia , Leiomiossarcoma/patologia , Leiomiossarcoma/secundário , Leiomiossarcoma/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Resultado do Tratamento , Neoplasias Uterinas/patologia , Neoplasias Uterinas/terapia , Vagina/patologia , Vagina/cirurgia , Neoplasias Vaginais/patologia
3.
BMC Public Health ; 21(1): 1071, 2021 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090372

RESUMO

BACKGROUND: Cervical cancer, although preventable, is the fourth most common cancer among women globally, and the second most common and deadliest gynaecological cancer in low-and-middle-income countries. Screening is key to the prevention and early detection of the disease for treatment. A few studies estimated the prevalence of cervical cancer screening and its correlates in Cameroon but relied on data that were limited to certain regions of the country. Therefore, this study sought to examine the prevalence and correlates of cervical cancer screening among Cameroonian women using current data that is nationally representative of reproductive-age women. METHODS: We used secondary data from the 2018 Cameroon Demographic and Health Survey. Summary statistics were used for the sample description. We employed the Firth logistic regression using the "firthlogit" command in STATA-14 to perform the bivariate analyses between the outcome variable and each of the explanatory variables. Given that all the explanatory variables were statistically significant correlates, they were all adjusted for in a multivariable analysis. All analyses were performed in STATA version 14. RESULTS: The proportion of Cameroonian women who have ever screened for cervical cancer continue to remain low at approximately 4%. In the adjusted model, women with the following sociodemographic characteristics have a higher likelihood of undergoing cervical cancer screening: ever undergone HIV screening (AOR = 4.446, 95% CI: 2.475, 7.986), being 24-34 years (AOR = 2.233, 95% CI: 1.606, 3.103) or 35-44 years (AOR = 4.008, 95% CI: 2.840, 5.657) or at least 45 years old (AOR = 5.895, 95% CI: 3.957, 8.784), having attained a post-secondary education (AOR = 1.849, 95% CI: 1.032, 3.315), currently (AOR = 1.551, 95% CI: 1.177, 2.043) or previously married (AOR = 1.572, 95% CI: 1.073, 2.302), dwelling in the richest household (AOR = 4.139, 95% CI: 1.769, 9.682), and residing in an urban area (AOR = 1.403, 95% CI: 1.004,1.960). Except for the North-West region, residing in some five regions, compared to Yaounde, was negatively associated with cervical cancer screening. CONCLUSION: Cervical cancer screening programs and policies should target Cameroonian women who are younger, less educated, and those in poor households and rural areas.


Assuntos
Detecção Precoce de Câncer , Neoplasias do Colo do Útero , Camarões/epidemiologia , Estudos Transversais , Análise de Dados , Feminino , Humanos , Casamento , Pessoa de Meia-Idade , Prevalência , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia
4.
Medicine (Baltimore) ; 100(19): e25637, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34106591

RESUMO

ABSTRACT: Breast cancer has the highest incidence of cancer among women in Taiwan, and air pollutants have been documented to have multiple adverse effects on human health. There is no relevant data, there has been no research in Taiwan to discuss the relevance of air pollutants to breast cancer, and evidence is sparse and inconclusive.Air quality data used in this study was collected from the 78 air quality monitoring stations situated in 74 municipalities in Taiwan during 2000 to 2011. The daily measurements taken at each monitoring station represented the level of exposure for each participant residing in that zone. The air pollution concentration is partitioned based on the concentration level in Quartile. We calculate the annual average air pollutants concentration (CO, NO, NO2, PM2.5, THC, and CH4) and the long-term average exposure levels of these pollutants until diagnosis of breast cancer, ending the study period for each individual.Patients who were living in areas with the highest air pollutants concentration (Quartile 4) had the most people diagnosed with breast cancer (CO:1.47%, NO:1.41%, NO2:1.63%, PM2.5:0.91%, THC:1.53%, CH4:2.33%). The patients who were exposed to Quartile 1 level of CO, NO, and NO2 concentration were the oldest, and other patients who were exposed to Quartile 4 level of CO, NO, and NO2 concentration were living in the areas of highest urbanization. Participants exposed to Quartile 4 level concentrations of air pollutants were associated with highest hazards ratios for breast cancer incidences.Most participants who were exposed to the high concentration of air pollutants (CO, THC and CH4) had a significantly higher risk of breast cancer. If we can improve air pollution in the environment, we can reduce the incidence of breast cancer and save precious medical resources.


Assuntos
Poluição do Ar/efeitos adversos , Neoplasias da Mama/epidemiologia , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Neoplasias da Mama/diagnóstico , Monitoramento Ambiental , Feminino , Humanos , Pessoa de Meia-Idade , Material Particulado , Estudos Retrospectivos , Taiwan , Adulto Jovem
5.
Rev Col Bras Cir ; 48: e20202698, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34133654

RESUMO

OBJECTIVE: to evaluate symmetry after breast-conserving surgery (BCS) for cancer. METHODS: a prospective study of patients undergoing BCS. These patients were photographed using the same criteria of evaluation. The references points used were the nipple height difference (NH), the nipple-manubrium distances (NM), nipple-sternum distances (NS) and the angle between the intramammary fold and the nipple (nipple angle; NA). ImageJ software was used. Three breast symmetry models were evaluated: excellent/others (model 1), excellent-good/others (model 2) and others/poor (model 3). The ROC curve was used to select acceptable criteria for the evaluation of symmetry. Decision tree model analysis was performed. RESULTS: a total of 274 women were evaluated. The BCCT.core result was excellent in 5.8% (16), good in 24.1% (66), fair in 46.4% (127) and poor in 23.7% (65). The difference in NH was associated with good breast area (0.837-0.846); acceptable differences were below 3.1 cm, while unacceptable values were greater than 6.4 cm. Differences in the NM were associated with average breast area (0.709-0.789); a difference in value of less than 4.5 cm was acceptable, while values greater than 6.3 cm were unacceptable. In the decision tree combined model, a good-excellent outcome for patients with differential (d) dNH = 1 (0 to 5.30 cm) and dNM ≠ 3 (<6.28 cm); and for a poor/poor result, values dNM = 3 (> 6.35). CONCLUSIONS: the results presented here are simple tools that can assist the surgeon for breast symmetry evaluation.


Assuntos
Neoplasias da Mama , Neoplasias , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia Segmentar , Estudos Prospectivos , Resultado do Tratamento
6.
BMC Bioinformatics ; 22(1): 331, 2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34134623

RESUMO

BACKGROUND: Accurately forecasting the prognosis could improve cervical cancer management, however, the currently used clinical features are difficult to provide enough information. The aim of this study is to improve forecasting capability by developing a miRNAs-based machine learning survival prediction model. RESULTS: The expression characteristics of miRNAs were chosen as features for model development. The cervical cancer miRNA expression data was obtained from The Cancer Genome Atlas database. Preprocessing, including unquantified data removal, missing value imputation, samples normalization, log transformation, and feature scaling, was performed. In total, 42 survival-related miRNAs were identified by Cox Proportional-Hazards analysis. The patients were optimally clustered into four groups with three different 5-years survival outcome (≥ 90%, ≈ 65%, ≤ 40%) by K-means clustering algorithm base on top 10 survival-related miRNAs. According to the K-means clustering result, a prediction model with high performance was established. The pathways analysis indicated that the miRNAs used play roles involved in the regulation of cancer stem cells. CONCLUSION: A miRNAs-based machine learning cervical cancer survival prediction model was developed that robustly stratifies cervical cancer patients into high survival rate (5-years survival rate ≥ 90%), moderate survival rate (5-years survival rate ≈ 65%), and low survival rate (5-years survival rate ≤ 40%).


Assuntos
MicroRNAs , Neoplasias do Colo do Útero , Algoritmos , Feminino , Humanos , Aprendizado de Máquina , MicroRNAs/genética , Taxa de Sobrevida , Neoplasias do Colo do Útero/genética
7.
Int J Mol Sci ; 22(10)2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34068980

RESUMO

Ultraviolet (UV) exposure has been linked to skin damage and carcinogenesis, but recently UVB has been proposed as a therapeutic approach for cancer. Herein, we investigated the cellular and molecular effects of UVB in immortal and tumorigenic HPV positive and negative cells. Cells were irradiated with 220.5 to 1102.5 J/m2 of UVB and cell proliferation was evaluated by crystal violet, while cell cycle arrest and apoptosis analysis were performed through flow cytometry. UVB effect on cells was recorded at 661.5 J/m2 and it was exacerbated at 1102.5 J/m2. All cell lines were affected by proliferation inhibition, cell cycle ablation and apoptosis induction, with different degrees depending on tumorigenesis level or HPV type. Analysis of the well-known UV-responsive p53, E2F1 and microtubules system proteins was performed in SiHa cells in response to UVB through Western-blotting assays. E2F1 and the Microtubule-associated protein 2 (MAP2) expression decrease correlated with cellular processes alteration while p53 and Microtubule-associated Protein 1S (MAP1S) expression switch was observed since 882 J/m2, suggesting they were required under more severe cellular damage. However, expression transition of α-Tubulin3C and ß-Tubulin was abruptly noticed until 1102.5 J/m2 and particularly, γ-Tubulin protein expression remained without alteration. This study provides insights into the effect of UVB in cervical cancer cell lines.


Assuntos
Fator de Transcrição E2F1/metabolismo , Regulação Neoplásica da Expressão Gênica/efeitos da radiação , Microtúbulos/efeitos da radiação , Proteína Supressora de Tumor p53/metabolismo , Raios Ultravioleta , Neoplasias do Colo do Útero/patologia , Apoptose , Ciclo Celular , Proliferação de Células , Fator de Transcrição E2F1/genética , Feminino , Humanos , Células Tumorais Cultivadas , Proteína Supressora de Tumor p53/genética , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/metabolismo , Neoplasias do Colo do Útero/radioterapia
8.
Artigo em Inglês | MEDLINE | ID: mdl-34128292

RESUMO

Carcinomatous meningitis presents with a variety of neurological symptoms and has a poor prognosis. We encountered a case of carcinomatous meningitis from cervical cancer. A 30-year-old patient was diagnosed with cervical cancer (glassy cell carcinoma), stage IIB. She underwent radical hysterectomy and chemoradiotherapy. Nine months later, the disease recurred with iliac lymph node and right lung metastases. The patient received chemotherapy; however, after seven cycles, the lung lesions increased. The patient responded to supportive care; nevertheless, symptoms including headaches developed and were followed by diplopia. A contrast-enhanced magnetic resonance image of the head confirmed the diagnosis of carcinomatous meningitis. She was transferred to the palliative care unit and died approximately 1 week later. Carcinomatous meningitis has a poor prognosis and is difficult to treat; however, early diagnosis may provide meaningful time to patients. Therefore, attention must be paid to meningeal irritation and neurological symptoms.

9.
Artigo em Inglês | MEDLINE | ID: mdl-34063854

RESUMO

Breast cancer (BC) is the cancer with the highest incidence in women in the world. In this last period, the COVID-19 pandemic has caused in many cases a drastic reduction of routine breast imaging activity due to the combination of various factors. The survival of BC is directly proportional to the earliness of diagnosis, and especially during this period, it is at least fundamental to remember that a diagnostic delay of even just three months could affect BC outcomes. In this article we will review the state of the art of breast imaging, starting from morphological imaging, i.e., mammography, tomosynthesis, ultrasound and magnetic resonance imaging and contrast-enhanced mammography, and their most recent evolutions; and ending with functional images, i.e., magnetic resonance imaging and contrast enhanced mammography.


Assuntos
Neoplasias da Mama , COVID-19 , Neoplasias da Mama/diagnóstico por imagem , Diagnóstico Tardio , Feminino , Humanos , Imageamento por Ressonância Magnética , Mamografia , Pandemias , SARS-CoV-2
10.
Rev Med Liege ; 76(5-6): 502-506, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080387

RESUMO

Breast cancer is the leading cause of neoplastic death in women around the world. In the era of personalized medicine, legitimately awaited by our patients, the future of breast cancer screening will depend on an individual-based risk assessment, making it possible to better adapt the age of onset, frequency and the type of examinations useful for this screening. This article reviews the three broad categories of highest risk factors available to establish a risk score appropriate for each patient.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer , Feminino , Humanos , Medicina de Precisão , Medição de Risco , Fatores de Risco
11.
Rev Med Liege ; 76(5-6): 507-514, 2021 05.
Artigo em Francês | MEDLINE | ID: mdl-34080388

RESUMO

Cervical cancer is the fourth most common cancer in women and is linked in over 95 % of cases to papillomavirus infection, the incidence of which has fallen in recent years due to screening and vaccination. Almost half of these cancers are diagnosed at a locally advanced stage with an overall 5-year survival of around 65 %. In recent decades, the management strategy of these locally advanced cancers has changed considerably and has allowed the improvement of survival but above all of local control as well as the reduction of toxicity, due to the implementation of imaging. Standard treatment consists of external beam radiation therapy combined with concomitant chemotherapy followed by intrauterine brachytherapy. The role of neo-adjuvant and adjuvant chemotherapy is still being evaluated. New therapeutic approaches (particularly immunotherapy) in addition to standard treatment are also being studied.


Assuntos
Braquiterapia , Neoplasias do Colo do Útero , Quimioterapia Adjuvante , Feminino , Humanos , Estadiamento de Neoplasias , Dosagem Radioterapêutica , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/terapia
12.
Health Res Policy Syst ; 19(1): 87, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059055

RESUMO

BACKGROUND: Sexual and reproductive health problems significantly decrease quality of life in survivors of breast cancer. The best approach is to provide services according to evidence-based guidelines developed based on their practical context. Here, we aim to develop and validate a guideline on the sexual and reproductive health of breast cancer survivors in Iran. METHODS: The guideline will be developed and validated using an exploratory sequential mixed methods approach in three phases: (1) describing sexual and reproductive health needs of survivors of breast cancer in Iran and the health services they receive in this regard, (2) performing a systematic review of existing guidelines, resources, and documents on the sexual and reproductive health of breast cancer survivors worldwide, and (3) developing and validating a guideline on the sexual and reproductive health of women who survived breast cancer in Iran based on the results of phases 1 and 2 through multiple steps. DISCUSSION: A comprehensive and practical guideline on the sexual and reproductive health of breast cancer survivors in Iran will be developed which will be compatible with their specific needs and culture, considering the limited resources available. This guideline can significantly improve the quality of life in breast cancer survivors in Iran. In addition, the approach we will use here can be utilized to develop guidelines on sexual and reproductive health of female cancer survivors in general.


Assuntos
Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Guias de Prática Clínica como Assunto , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Neoplasias da Mama/reabilitação , Feminino , Humanos , Irã (Geográfico) , Saúde Reprodutiva , Revisões Sistemáticas como Assunto
13.
J Med Case Rep ; 15(1): 279, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34059119

RESUMO

BACKGROUND: Polyps of the uterine cervix are one of the most common benign hyperplastic lesions occurring in the female genital tract that usually arise from the endocervical canal and are believed to be the result of reactive changes due to long-standing chronic inflammation, multiparty, and foreign bodies. Cervical polyps are usually small in size (less than 4 cm) that are commonly found in adult women; however, a few cases of giant polyps and the rare occurrence of these lesions in children have also been reported. Heterotopias and malignant transformation in cervical polyps are considered to be very rare. CASE PRESENTATION: We present the case of a 10-year-old Afghan girl with a giant pedunculated mass protruding out of the uterine cervix that was accompanied by abdominal pain and mass sensation. The mass was completely excised by surgical intervention and the specimen was submitted for histopathological evaluation. Upon gross and microscopic examination, the characteristic findings of a hamartomatous polyp with heterologous mesenchymal tissue in the form of mature cartilage were seen. To the best of our knowledge, this is the first case of a giant (17.5 cm) hamartomatous polyp of the uterine cervix in this age group. CONCLUSION: Giant hamartomatous cervical polyps rarely occur in patients below 10 years of age. The majority of these lesions are benign; however, a few cases with malignant transformation are also reported, which demands elaborate investigations into the etiopathogenesis and nature of the lesions.


Assuntos
Hamartoma , Neoplasias do Colo do Útero , Adulto , Transformação Celular Neoplásica , Criança , Família , Feminino , Humanos , Neoplasias do Colo do Útero/cirurgia
14.
Medicina (Kaunas) ; 57(6)2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-34072478

RESUMO

Background and Objectives: In October 2018, the International Federation of Gynecology and Obstetrics (FIGO) revised its classification of advanced stages of cervical cancer. The main points of the classification are as follows: stage IIIC is newly established; pelvic lymph node metastasis is stage IIIC1; and para-aortic lymph node metastasis is stage IIIC2. Currently, in Japan, radical hysterectomy is performed in advanced stages IA2 to IIB of FIGO2014, and concurrent chemoradiotherapy (CCRT) is recommended for patients with positive lymph nodes. However, the efficacy of CCRT is not always satisfactory. The aim of this study was to compare postoperative adjuvant chemotherapy (CT) and postoperative CCRT in stage IIIC1 patients. Materials and Methods: Of the 40 patients who had undergone a radical hysterectomy at Iwate Medical University between January 2011 and December 2016 and were pathologically diagnosed as having positive pelvic lymph nodes, 21 patients in the adjuvant CT group and 19 patients in the postoperative CCRT group were compared. Results: The 5 year survival rates were 77.9% in the CT group and 74.7% in the CCRT group, with no significant difference. There was no significant difference in overall survival or progression-free survival between the two groups. There was no significant difference between CT and CCRT in postoperative adjuvant therapy in the new classification IIIC1 stage. Conclusions: The results of the prospective Japanese Gynecologic Oncology Group (JGOG) 1082 study are pending, but the present results suggest that CT may be a treatment option in rural areas where radiotherapy facilities are limited.


Assuntos
Neoplasias do Colo do Útero , Quimiorradioterapia , Quimiorradioterapia Adjuvante , Quimioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Humanos , Japão , Estadiamento de Neoplasias , Estudos Prospectivos , Estudos Retrospectivos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapia
16.
Medicine (Baltimore) ; 100(22): e26245, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087912

RESUMO

BACKGROUND: Breast cancer was the second cause of cancer death and approximately accounted for 30% of all newly diagnosed cancer in American women. Adjuvant chemotherapy is the preferred treatment approach for breast patients. Kanglaite injection (KI) was commonly used as adjuvant chemotherapy combined with chemotherapy for women breast cancer which could increase chemotherapy efficacy and alleviate chemotherapy drugs induced adverse events, however, the efficacy and safety for KI combined western medicine remains controversial. Thus, we conducted this protocol of systematic review and meta-analysis to estimate the efficacy and safety of KI combined with western medicine for women breast cancer. METHODS: This study will search electronic database included English medicals databases and Chinese databased up to May 2021. The main outcomes of this study include clinical efficacy rate. Adverse reaction rate, Karnofsky Performance Status and immune function were defined as the secondary outcomes. RESULTS: This protocol study will comprehensively evaluate the efficacy and safety of KI combined with chemotherapy for women breast cancer. CONCLUSION: This protocol for systematic review and meta-analysis will evaluate the efficacy and safety of KI combined with chemotherapy for women breast cancer, aiming to provide optimal therapy for women breast cancer patients.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Carcinoma/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Adulto , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/mortalidade , Carcinoma/diagnóstico , Quimioterapia Adjuvante/métodos , Gerenciamento de Dados , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Neoplasias Esofágicas/patologia , Feminino , Humanos , Avaliação de Estado de Karnofsky , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Resultado do Tratamento
17.
Pol J Pathol ; 72(1): 75-83, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34060290

RESUMO

In our pilot study we have aimed to assess interlaboratory variability of cytological diagnoses in selected laboratories participating in the Polish Cervical Cancer Screening Programme (CCSP) to establish grounds for certification system for cytodiagnosticians and to monitor the quality of services. Set of 50 selected Pap smears, previously reassessed by an expert on the grounds of clinical, colposcopic and histological data was blinded and sent to 15 laboratories in Poland with request for evaluation according to routine practice according to the Bethesda 2001 system. Concordance with expert diagnoses reached a median of 82% (range: 66% to 92%), with median unweighted κ coefficient at κ = 0.67 (range 0.40 to 0.86) depending on laboratory. This indicates substantial agreement among laboratories, however with essential differences in proper evaluation in some outlying laboratories. Agreement was highest in samples with high-grade, lower for low-grade abnormalities. Slides with ASC-US and ASC-H expert diagnoses were most troubling for cytodiagnosticians. Sets of highly selected cytological slides with expert diagnoses may serve as a tool in the process of comprehensive periodic recertification of cytodiagnosticians in the screening programme. A benchmark level of agreement with expert diagnoses should be established to guide corrective actions for cytodiagnosticians with lowest agreement.


Assuntos
Neoplasias do Colo do Útero , Detecção Precoce de Câncer , Feminino , Humanos , Projetos Piloto , Polônia , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal
18.
J Rural Health ; 2021 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-34081371

RESUMO

PURPOSE: Differences in hysterectomy prevalence by rural or urban residence could distort comparisons of rural-urban cervical and uterine cancer incidence. Using data from a large population-based survey, we sought to understand whether hysterectomy prevalence varies by rural or urban residence and whether the relationship between hysterectomy prevalence and rurality varies by race or ethnicity. METHODS: Our analysis included 197,759 female respondents to the 2018 Behavioral Risk Factor Surveillance System, aged 20-79 years. We calculated population weighted proportions and 95% confidence intervals for hysterectomy prevalence, stratified by rural-urban residence and 5-year age groups. We also report estimates of hysterectomy prevalence by rural-urban residence for specific race and ethnic groups. FINDINGS: Hysterectomy prevalence increased with age and was more common among rural women than urban women. The largest absolute difference occurred among women aged 45-49 years; 28.6% of rural women (95% CI: 25.1-32.2) and 16.6% of urban women (95% CI: 15.3-17.8) reported a hysterectomy. For hysterectomy prevalence by race and ethnicity, rural estimates were higher than urban estimates for the following groups of women: non-Hispanic Asian, non-Hispanic other race, non-Hispanic Black, and non-Hispanic White. Among Hispanic women and non-Hispanic American Indian/Alaska Native women, rural-urban differences in hysterectomy prevalence were not statistically different at the 95% confidence level. CONCLUSIONS: Our results suggest that variation in hysterectomy prevalence, if not adjusted in the analysis, could produce distorted comparisons in measures of the relationship between rurality and uterine and cervical cancer rates. The magnitude of this confounding bias may vary by race and ethnicity.

19.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 37(6): 520-526, 2021 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-34060447

RESUMO

Objective To explore the effect of glucose-6-phsophatase, catalytic subunit (G6PC) on the proliferation, migration and invasion of cervical cancer HeLa cells and the possible molecular mechanism. Methods RNA interfering (RNAi) was used to knockdown the expression of G6PC in HeLa cells, and the silencing effect of protein was confirmed by Western blotting. MTT assay and plate clony formation assay were performed to detect the effect of G6PC knockdown on the proliferation of HeLa cells; scratch healing assay and TranswellTM chamber assay were applied to observe the effect of G6PC knockdown on the invasion and migration abilities of HeLa cells; the tube-formation assay was used to detect the effect of G6PC knockdown on the angiogenesis ability of HeLa cells; the expression levels of epithelial-mesenchymal transition (EMT)-related proteins and AKT/mTOR signaling pathway-related proteins were determined by Western blotting. Results The expression of G6PC was effectively silenced by RNAi technology. G6PC knockdown obviously inhibited the proliferation, migration and angiogenesis of HeLa cells. Meanwhile, G6PC knockdown suppressed the EMT process, the phosphorylation of AKT and mTOR proteins. Conclusion G6PC knockdown can effectively inhibit the proliferation, migration, angiogenesis and EMT process of HeLa cells, which is related to the blocked AKT/mTOR signaling pathway.


Assuntos
Proteínas Proto-Oncogênicas c-akt , Neoplasias do Colo do Útero , Domínio Catalítico , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células , Feminino , Glucose , Células HeLa , Humanos , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Serina-Treonina Quinases TOR/genética , Serina-Treonina Quinases TOR/metabolismo , Neoplasias do Colo do Útero/genética
20.
Int J Clin Oncol ; 2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34106355

RESUMO

OBJECTIVE: The aim of this retrospective analysis is to reveal clinicopathological findings and clinical outcome of patients with stage IB1/IB2 (FIGO 2018) uterine cervical cancer. METHODS: Based on the database of the Japanese Gynecologic Oncology Group, 2194 patients with stage IB1/IB2 (FIGO 2018), who underwent radical hysterectomy between 1/1/2004-12/31/2008, were identified as eligible for this retrospective study. RESULTS: Patients with squamous cell carcinoma had significantly frequent lympho-vascular space invasion than those with non-squamous cell carcinoma in both stage IB1 and IB2 (stage IB1; 29.1% vs. 17.1%, p < 0.0001, stage IB2; 50.5% vs. 39.7%, p = 0.0009). Among 1262 patients with stage IB1, 61.2% (772/1262) were low-risk group, 29.4% (371/1262) were intermediate-risk group (single risk: 23.3%, double risks: 6.1%). Of 932 patients with stage IB2, 32.1% (299/932) were low-risk group, 59.1% (551/932) were intermediate-risk group (single intermediate-risk: 31.0%, double intermediate-risk: 28.1%). Disease-free survival rate and overall survival rate of stage IB1 patients were significantly better than those with stage IB2 (5-year DFS; 94.7% vs. 88.6%, p < 0.001, 5-yrs OS; 98.5% vs. 95.1%, p < 0.001). Stage IB1 Patients with double intermediate-risk showed significantly worse survival than those with single intermediate-risk (5-yrs DFS: 96.1% vs. 84.6%, p < 0.001, 5-yrs OS: 98.9% vs. 93.0%, p = 0.029). Multivariate analysis revealed that double intermediate-risk was the independent prognostic factor in stage IB1, but non-squamous cell carcinoma and intermediate-risk in stage IB2. CONCLUSION: Non-squamous cell carcinoma and intermediate-risk decreased survival in patients with stage IB2, whereas double intermediate-risk was a negative impact on survival in stage IB1.

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