The Value of MicroRNA-375 Detection for Triaging Primary Human Papillomavirus Positive Women: A Cross-Sectional Study in a General Population.

PURPOSE: This study aims to validate the value of microRNA (miRNA) detection for triaging human papillomavirus (HPV)-positive women in the general population. PATIENTS AND METHODS: miR-375 detection in cervical exfoliated cells has been demonstrated to have the superior value to cytology in triaging primary HPV-positive women in the hospital population. In this study, residual samples of cervical exfoliated cells from 10,951 women in a general population were used to detect miRNA. The performance efficiency of miRNA detection in identifying high-grade cervical intraepithelial neoplasia (CIN) was evaluated. Pearson chi-square test and McNemar pairing test were used to compare miRNA detection and cytology. RESULTS: In valid 9,972 women aged 25-65, miR-375 expression showed a downward trend along with an increase in cervical lesion severity. The expression level of miR-375 ≤1.0 × 10-3 was identified as positive. In the HPV-positive and 12 HPV genotypes other than 16/18 (HR12)-positive women, miR-375 detection showed equivalent sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to that of cytology (≥ASC-US) and higher or similar sensitivity and NPV but lower specificity and PPV than that of cytology (≥ASC-H) in identifying CIN3+ and CIN2+. In HPV 16-positive women, miR-375 positivity had higher sensitivity and NPV but lower specificity and PPV than that of cytology (≥ASC-H and HSIL) in identifying CIN3+ and CIN2+. The immediate CIN3+ risk of miR-375 positivity was 19.8% (61/308) in HPV-positive, 10.8% (22/204) in HR12-positive, and 43.5% (37/85) in HPV16-positive women, respectively. CONCLUSION: The detection of miR-375 in cervical exfoliated cells may be an optional method for triaging primary HPV-positive women in population-based cervical cancer screening.

Emerging relationships between papillary proliferation of the endometrium and endometrial carcinoma: evidence from an immunohistochemical and molecular analysis.

Papillary proliferation of the endometrium (PPE) is an uncommon lesion that frequently shows mucinous metaplasia. PPE occasionally has concurrent or preceding endometrial hyperplasia and carcinomas, but there is little molecular evidence to support the relationships between PPEs and endometrial neoplasia. In this study, we analyzed the clinicopathological and immunohistochemical features in 30 PPEs (22 simple PPEs and 8 complex papillary hyperplasia (CPH)). Hotspot mutations of KRAS, PI3KCA, AKT1, PTEN (exons 3, 5, and 7), and ARID1A (exons 1 and 14) were detected by pyrosequencing or bidirectional Sanger sequencing. We found that endometrial hyperplasia and carcinoma were more common in CPHs (4/6, 66.7%) than in simple PPEs (4/21, 19.0%) (p < 0.05). Compared with the adjacent normal endometrium, PPEs frequently showed loss of PAX2 (56.7%) and PTEN (10%) expression, diffuse p16 expression (36.7%), decreased PR expression (84.3%), and lower Ki67 labeling index (median 1%, range 1-15%). Simple PPEs and CPHs had similar immunohistochemical features (p > 0.05). KRAS mutations were identified in 14 PPEs and 1 concurrent endometrial carcinoma. The prevalence of KRAS mutations was not statistically different between simple PPEs (10/21, 45.5%) and CPHs (4/8, 50%) (p > 0.05), but was higher in PPEs displaying mucinous metaplasia (12/24, 50%) than in those without (2/6, 33.3%) (p < 0.05). One simple PPE with a KRAS mutation had an AKT1 mutation. No PPEs demonstrated mutations in PI3KCA, PTEN, and ARID1A. In conclusion, both simple PPE and CPH share some common molecular alterations with endometrial neoplasia, in which, KRAS mutations might be a driver.

Combining a Disturbance Observer with Triple-Loop Control Based on MEMS Accelerometers for Line-of-Sight Stabilization.

In the CCD-based fine tracking optical system (FTOS), the whole disturbance suppression ability (DSA) is the product of the inner loop and outer position loop. Traditionally, high sampling fiber-optic gyroscopes (FOGs) are added to the platform to stabilize the line-of-sight (LOS). However, because of the FOGs' high cost and relatively big volume relative to the back narrow space of small rotating mirrors, we attempt in this work to utilize a cheaper and smaller micro-electro-mechanical system (MEMS) accelerometer to build the inner loop, replacing the FOG. Unfortunately, since accelerometers are susceptible to the low-frequency noise, according to the classical way of using accelerometers, the crucial low-frequency DSA of the system is insufficient. To solve this problem, in this paper, we propose an approach based on MEMS accelerometers combining disturbance observer (DOB) with triple-loop control (TLC) in which the composite velocity loop is built by acceleration integration and corrected by CCD. The DOB is firstly used to reform the platform, greatly improving the medium-frequency DSA. Then the composite velocity loop exchanges a part of medium-frequency performance for the low-frequency DSA. A detailed analysis and experiments verify the proposed method has a better DSA than the traditional way and could totally substitute FOG in the LOS stabilization.

A cross-sectional study on HPV testing with type 16/18 genotyping for cervical cancer screening in 11,064 Chinese women.

Cytology-based cervical cancer screening is restricted because of a lack of cytologists. Thus, HPV-based instead of cytology-based screening may be a more suitable strategy in China. Here, we assessed the effectiveness of HPV testing (Cobas® 4800 Test, Roche) and HPV-based programs to detect high-grade cervical intraepithelial neoplasia (CIN) or cancer compared with cytology (Thinprep, Hologic) and cytology-based programs through a cross-sectional study in 11,064 Chinese women aged 21-65 years who were enrolled from Longyou County in Zhejiang Province, China. The rates of HPV positivity and cytology abnormality were 9.8% and 6.1%, respectively. The HPV positivity rate had two age peaks, 21-24 (15.4%) and 60-65 (14.4%) years. According to adjusted data, HPV testing demonstrated significantly higher sensitivity and negative predictive value (NPV) than cytology for detecting CIN2 or worse (90.0% vs. 66.7%, 99.9% vs. 99.5%), and there was an acceptable specificity (91.3%) and positive predictive value (PPV, 12.5%). Furthermore, primary HPV testing with type 16/18 genotyping showed the highest sensitivity (78.6%) and NPV (99.7%) among four screening strategies, and there was similar specificity (96.8%) and PPV (23.9%) compared with co-testing screening to detect CIN2+, while there were fewer colposcopies (4.2) and tests (106.3) performed than with co-testing and primary cytology screening to detect a case of high-grade CIN. The differences in effectiveness were approximately similar when CIN3+ was the identifying target. Our findings suggest that primary HPV testing with type 16/18 genotyping has a higher sensitivity and NPV, possesses optimal cost/effectiveness in the first round of screening and is a feasible strategy of cervical cancer screening for Chinese women.

Progress in prevention of mother-to-child transmission of HIV-1 in Zhejiang province, China, 2007-2013.

This is a retrospective study based on surveillance of Human Immunodeficiency Virus type-1 (HIV-1) positive pregnant women and their children in China's Zhejiang Province. HIV counseling and testing, mother and infant characteristics, and outcomes are reported here. This study compares two principal periods, the period from 2007-2009 and the period from 2010 to 2013. The average rate of HIV counseling among pregnant women rose from 84.87% during the earlier period to 99.08% during the latter period. And the rate of HIV testing also rose significantly, from 80.60% to 98.58%. The HIV-1 prevalence among pregnant women increased slightly, from 0.01% to 0.02%. Over 70% of infected women were migrants. Half of these HIV-1 positive pregnant women were 20-30 years old. Significant differences in the characteristics of HIV-1 positive pregnant women were observed with time. The proportion of women who were employed increased dramatically from an average of 15.03% during 2007-2009 to an average of 31.34% during 2010-2013 and the proportion of women who had completed high school education increased from 0.52% to 6.51%. During 2007-2009, an average of 3.11% of these women was diagnosed before their pregnancies. During 2010-2013, this average reached to 32.53%. Sexual contact remained the primary route of transmission route during both periods, accounting for half of the infections. The proportion of women who had acquired HIV by blood transfusion declined noticeably. The proportion of mothers and children with antiretroviral therapy increased considerably over time. The overall mother-to-child transmission rate was found to be 7.14%. Although some progress has been made, further work should be performed, fostering early identification and timely therapy. Particular attention should be paid to health care of migrants.

[Expression and clinical significance of Beclin1 and PTEN in endometrial carcinoma].

BACKGROUND & OBJECTIVE: The pathogenesis of endometrial carcinoma is unclear. This study was to explore the expression of beclin1 (BECN1) and PTEN in endometrial carcinoma, and investigate their correlations to clinicopathologic features of endometrial carcinoma. METHODS: The expression of BECN1 and PTEN in 79 specimens of endometrial carcinoma, 34 specimens of endometrial hyperplasia, and 22 specimens of normal endometria were detected by PowerVision immunohistochemistry. Their correlations to clinicopathologic features of endometrial carcinoma were analyzed. RESULTS: The positive rates of BECN1 and PTEN were the highest in normal endometria, and diminished gradually in endometrial hyperplasia and endometrial carcinoma (93.33%, 58.82%, and 34.18%, Chi (2)=42.318, P<0.001, 93.33%, 64.71%, and 32.91%, Chi(2)=31.746, P<0.001). The expression of BECN1 was correlated to cell differentiation and histological type, but not to pathologic stage and myometrial invasion. The expression of PTEN was correlated to cell differentiation, histological type, and myometrial invasion, but not to pathologic stage. The expression of BECN1 was positively correlated to that of PTEN in endometrial carcinoma. CONCLUSION: The down-regulation of BECN1 and PTEN may be correlated to carcinogenesis of endometrioid adenocarcinoma.