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1.
MMWR Morb Mortal Wkly Rep ; 70(12): 415-420, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33764964

RESUMEN

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (1). Although most infections resolve without clinical sequalae, persistent HPV infection can cause cervical, other anogenital, and oropharyngeal cancers and anogenital warts. HPV vaccination has been recommended in the United States at age 11-12 years since 2006 for females and since 2011 for males. Catch-up vaccination is recommended through age 26 years.* A quadrivalent vaccine (4vHPV) targeting types 6, 11, 16, and 18 was mainly used until 2015, when a 9-valent vaccine (9vHPV), targeting the same four types as 4vHPV and five additional types (31, 33, 45, 52, and 58), was introduced; 9vHPV has been the only vaccine available in the United States since the end of 2016 (2). HPV vaccination coverage has increased but remains lower than that of other vaccinations recommended for adolescents (3). A decrease in prevalence of 4vHPV types detected in cervicovaginal swabs among young females from the prevaccine era (2003-2006) to 2007-2010 in the National Health and Nutrition Examination Survey (NHANES) was an early indicator of vaccine impact (2) and was also observed in later periods (4,5). NHANES data from 2017-2018 were included in this analysis to update HPV prevalence estimates among females aged 14-34 years. From the prevaccine era to 2015-2018, significant decreases in 4vHPV-type prevalence occurred among females aged 14-19 years (88%) and 20-24 years (81%). In sexually experienced females, 4vHPV-type prevalence decreased in those who reported receiving ≥1 HPV vaccine dose (97% among those aged 14-19 years, 86% among those aged 20-24 years) and in those who reported no vaccination (87% among those aged 14-19 years, 65% among those aged 20-24 years). Significant declines among unvaccinated females suggest herd effects. These data show increasing impact of HPV vaccination in the United States. HPV vaccination is a critical prevention tool against HPV infection, anogenital warts, and HPV-attributable precancers and cancers. HPV vaccination is highly effective and is recommended routinely at age 11-12 years and through 26 years for persons not already vaccinated.


Asunto(s)
Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Adolescente , Adulto , Femenino , Genotipo , Humanos , Papillomaviridae/genética , Prevalencia , Estados Unidos/epidemiología , Adulto Joven
2.
Artículo en Inglés | MEDLINE | ID: mdl-33765753

RESUMEN

INTRODUCTION: The World Health Organization elimination goal for cervical cancer relies on screening 70% of women at ages 35 and 45, preferentially through molecular HPV testing. The SARS-CoV-2 pandemic has led to an unprecedented demand for molecular tests and platforms. Our objective was to gain insight into the impact of SARS-CoV-2 on the actual or anticipated shortage of tests, equipment, consumables, and staff required to deliver molecular HPV laboratory services and to consider the implications for the sustainability and development of cervical screening programs. METHODS: A 19-item online questionnaire was created and made available online between December 2020 and February 2021. Five companies with clinically validated HPV and SARS-CoV-2 tests in their portfolios were invited to provide a statement on the volumes of molecular COVID-19 tests produced, relevant changes to manufacturing capacity, and their current and post-pandemic strategy for HPV tests. RESULTS: We received responses from 57 laboratories representing 30 countries and six continents. Among these, 74% reported experiencing a supply shortage, 54% reported a shortage of personnel, and 33% reported delays in ordering equipment. Three companies described expansion of manufacturing lines, investment in diagnostic infrastructure, and scale-up of manufacturing capacity. Two companies specifically referred to opportunities for the use of platforms for COVID-19 testing to support HPV testing in time. CONCLUSIONS: The demand for SARS-CoV-2 testing is competing with HPV testing, compounded by a shortage of staff. This represents a challenge for existing laboratory services and for settings keen to implement HPV-based screening. However, supply challenges may be addressed in time, given the significant investment in manufacturing capacity. In addition, innovation around molecular COVID-19 testing systems may result in solutions that address the shortage of rapid low-cost HPV testing systems for low-resource settings. Finally, because the demand for COVID-19 testing is likely to decrease, this may release both workforce and platform capacity for high-throughput HPV testing. The global health community should be alert to the opportunities around innovation and capacity if cervical cancer elimination goals are to be reached.


Asunto(s)
/epidemiología , Tamizaje Masivo/estadística & datos numéricos , Infecciones por Papillomavirus/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Detección Precoz del Cáncer/estadística & datos numéricos , Femenino , Humanos , Persona de Mediana Edad , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/prevención & control , Neoplasias del Cuello Uterino/prevención & control , Adulto Joven
3.
Pan Afr Med J ; 38: 40, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33777308

RESUMEN

Introduction: head and neck cancers have essentially been a disease of the elderly but recent studies are beginning to demonstrate their increasing incidence in young people with infections such as human papilloma virus (HPV). This study was carried out to determine the prevalence of high risk Human papilloma virus (hrHPV) related oropharyngeal carcinoma and its prevalent genotypes as well as their strength of association with HIV in adult Nigerian subjects. Methods: this was a cross-sectional study of 41 patients with oropharyngeal carcinomas seen over a 2-year period. Patients had incisional and/or excisional biopsy done under anesthesia. A portion of the specimen from which the DNA was extracted was placed in Digene HC2 DNA collection device while the 2nd portion for histopathological analysis was fixed using 10% Neutral Buffered Formalin (NBF) and embedded in paraffin blocks. Oropharyngeal cancer HPV genotyping was done using HPV genotypes 14 real-tm quant kit (SACACE, Italy). The data was analyzed using SPSS version 23. Results: prevalence of HPV was 17.1% with a male to female ratio of 2.7: 1. The identified genotypes were 16, 33, 35 and 52 with 28.6% of patients having more than one genotype. Most of the age groups studied were affected. Squamous cell carcinoma and ameloblastic carcinoma were the cancers associated with HPV. HPV was not identified in the HIV positive patients. Conclusion: high-risk human papilloma virus genotypes 16, 33, 35 and 52 are associated with oropharyngeal carcinoma in Nigeria but were not found in HIV patients. This finding provides a strong evidence for the use of the 9-valent prophylactic vaccine for the prevention of oropharyngeal cancer in Nigeria. Public awareness and HPV prevention strategies should reduce significantly the incidence of oropharyngeal carcinomas in our environment.


Asunto(s)
Neoplasias Orofaríngeas/virología , Papillomaviridae/genética , Infecciones por Papillomavirus/complicaciones , Adulto , Anciano , Ameloblastoma/epidemiología , Ameloblastoma/virología , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/virología , Estudios Transversales , ADN Viral/genética , Femenino , Genotipo , Infecciones por VIH/epidemiología , Neoplasias de Cabeza y Cuello/epidemiología , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/virología , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Neoplasias Orofaríngeas/epidemiología , Neoplasias Orofaríngeas/patología , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Prevalencia , Adulto Joven
4.
Arch Virol ; 166(4): 1157-1161, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33550506

RESUMEN

Numerous raised plaques were observed on the feet of a red-billed gull (Chroicocephalus novaehollandiae scopulinus) that had been found dead. The plaques consisted of thickened epidermis with cell changes indicative of papillomavirus (PV) infection prominent within affected areas. Evidence suggesting progression to neoplasia was visible in one lesion. A DNA sequence that was most similar, but only 68.3% identical, to duck PV type 3 was amplified from the papillomas, suggesting a novel PV type. Lesions containing PV DNA have only previously been reported in three avian species. This is the first evidence that PVs could cause neoplasia in birds.


Asunto(s)
Enfermedades de las Aves/virología , Carcinoma in Situ/veterinaria , Charadriiformes/virología , Papiloma/veterinaria , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/veterinaria , Animales , Enfermedades de las Aves/patología , Proteínas de la Cápside/genética , Carcinoma in Situ/patología , Carcinoma in Situ/virología , ADN Viral/genética , Pie/patología , Pie/virología , Papiloma/patología , Papiloma/virología , Papillomaviridae/clasificación , Papillomaviridae/genética , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/virología , Filogenia
5.
J Cancer Res Clin Oncol ; 147(4): 1125-1135, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33635430

RESUMEN

PURPOSE: Penile carcinoma is a rare malignant neoplasm with a largely unknown molecular pathogenesis. Telomerase reverse transcriptase promoter (TERT-p) mutations have been detected in several types of human malignancies. The aim of this study was to investigate the presence of TERT-p mutations in penile squamous cell carcinomas (SCCs) and their associations with clinicopathologic features. METHODS: In this retrospective study, Sanger sequencing was performed to detect TERT-p mutations in formalin-fixed paraffin-embedded tissue samples from 37 patients with penile SCC, 16 patients with cutaneous SCC, and 4 patients with non-neoplastic penile/skin tissue. The expression of p16INK4a and Ki-67 was investigated via immunohistochemistry. Associations of TERT-p mutation with clinicopathological factors, immunohistochemical results, and clinical outcome were statistically analyzed. RESULTS: Recurrent TERT-p mutations were identified in 18 out of 37 (48.6%) penile SCCs, including all 3 carcinoma in situ cases. TERT-p mutations were significantly more frequent in non-human papilloma virus (HPV)-related penile SCC types than in non-HPV-related penile SCC based on both histologic classification and p16INK4a immunoreactivity. Furthermore, TERT-p mutation was associated with a low histologic grade, low mitotic count, absence of necrosis, low Ki-67/MIB-1 labeling index, and absence of lymph node or distant metastasis. CONCLUSION: Our study shows TERT-p mutations are the most frequent somatic mutations in penile SCC. In addition, TERT-p mutations are far more frequent in non-HPV-related penile SCC than in HPV-related penile SCC, indicating TERT-p mutations may have a role in tumorigenesis distinct from HPV-related penile SCC.


Asunto(s)
Biomarcadores de Tumor/genética , Carcinoma de Células Escamosas/patología , Mutación , Infecciones por Papillomavirus/complicaciones , Neoplasias del Pene/patología , Regiones Promotoras Genéticas , Telomerasa/genética , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/metabolismo , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/virología , Estudios de Casos y Controles , Inhibidor p16 de la Quinasa Dependiente de Ciclina/genética , Inhibidor p16 de la Quinasa Dependiente de Ciclina/metabolismo , Femenino , Estudios de Seguimiento , Humanos , Antígeno Ki-67/genética , Antígeno Ki-67/metabolismo , Masculino , Persona de Mediana Edad , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/virología , Neoplasias del Pene/genética , Neoplasias del Pene/virología , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia
6.
Zhonghua Fu Chan Ke Za Zhi ; 56(2): 114-120, 2021 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-33631883

RESUMEN

Objective: To analyze the characteristics of high-grade squamous intraepithelial lesion (HSIL) diagnosed by cervical tissue sampling in postmenopausal women. Methods: A retrospective study was performed on 2 013 patients with HSIL diagnosed by cervical tissue sampling under colposcopy and treated by cervical conization at the First Affiliated Hospital of Zhengzhou University from June 2017 to November 2018, to compare the difference of patients' clinical features, HPV test, liquid-based thin-layer cytology (TCT), performance of colposcopy and biopsy pathology, pathology after cervical conization between 439 postmenopausal patients and 1 574 pre-menopausal patients. Results: (1) Clinical features: the proportion of contact bleeding showed no significant difference between postmenopausal patients and pre-menopausal patients [4.3% (19/439) vs 6.4% (101/1 574); χ²=2.672, P=0.102]. Among the patients with contact bleeding, the proportion of cervical cancer after cervical cone resection was significantly higher in postmenopausal patients compared with pre-menopausal patients [10/19 vs 22.8% (23/101); χ²=7.157, P=0.007]. Among the patients found by routine screening, the proportion of cervical cancer after cervical cone resection was significantly higher in postmenopausal patients compared with pre-menopausal patients [9.0% (38/420) vs 4.3% (63/1 473); χ²=14.726, P<0.01]. The proportion of smooth cervix was higher in postmenopausal patients compared with pre-menopausal patients [63.6% (279/439) vs 35.5% (558/1 574); χ²=111.601, P<0.01]. (2) High-risk HPV infection: there was no significant difference in the high-risk HPV positive rate between the postmenopausal group and the pre-menopausal group [92.0% (404/439) vs 94.4% (1 486/1 574); χ²=3.394, P=0.065]; the HPV 16 infection was the most common type, but there was no significant difference in the HPV 16 infection rate between the two groups [65.8% (289/439) vs 68.0% (1 070/1 574); χ²=0.722, P=0.395]. (3) TCT test: TCT test results included negative for intraepithelial lesion and malignancy (NILM), atypical squamous cell of undetermined signification (ASCUS), atypical squamous cells cannot exclude high-grade lesion (ASC-H), low grade squamous intraepithelial lesion (LSIL), HSIL, compared with the different results of TCT examination, there were not statistically significant difference between postmenopausal and pre-menopausal patients (all P>0.05). (4) The performance of colposcopy: the proportion of insufficient colposcopy and the proportion of cervical type Ⅲ conversion area were higher in postmenopausal patients compared with pre-menopausal patients [87.5% (384/439) vs 32.5% (511/1 574), P<0.01; 80.0% (351/439) vs 21.9% (344/1 574), P<0.01]. The proportion and positive rate of endocervical curettage (ECC) in postmenopausal patients were higher than those in pre-menopausal patients [35.3% (155/439) vs 20.4% (322/1 574), P<0.01; 67.7% (105/155) vs 53.1% (171/322), P=0.003]. The proportion of lesions involving the vaginal wall was higher in postmenopausal patients compared with pre-menopausal patients [5.9% (26/439) vs 1.0% (16/1 574); χ²=40.443, P<0.01]. There was a positive correlation between vaginal wall lesions and cervical lesions in postmenopausal patients (r=0.660, P<0.01). (5) Postoperative pathology: the positive rate of margin and the proportion of pathological escalation after cervical conization were significantly higher in postmenopausal patients compared with pre-menopausal patients [14.6% (64/439) vs 4.8% (75/1 574), 10.9% (48/439) vs 5.5% (86/1 574); P<0.01]. Conclusions: Colposcopy in postmenopausal women is often inadequate, and the cervix is mostly type Ⅲ transformation zone. The lesion in postmenopausal women is more likely to involve the cervical canal and vaginal wall. Clinical attention should be paid to cervical tube curettage and comprehensive examination of the vaginal wall. The high rate of positive margins and a high proportion of pathological upgrading after cervical conization in postmenopausal patients requires further active intervention.


Asunto(s)
Biopsia/métodos , Colposcopía/métodos , Posmenopausia , Lesiones Precancerosas/epidemiología , Adulto , Femenino , Humanos , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/patología , Embarazo , Estudios Retrospectivos , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/cirugía , Frotis Vaginal/métodos
7.
PLoS One ; 15(12): e0244242, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33373380

RESUMEN

In context of the ongoing multi-centric HPV vaccine study in India, unvaccinated married women (N = 1484) aged 18-23 years were recruited in 2012-2015 as age-matched controls to the vaccinated women and followed up yearly. We assess type-specific prevalence, natural history and potential determinants of human papillomavirus (HPV) infection in these unvaccinated women. Cervical samples were collected yearly for at least four consecutive years. A Multiplex Type-Specific E7-Based polymerase chain reaction assay was used to detect 21 HPV types. HPV prevalence was 36.4% during 6 years. Most common HPV types were 16 (6.5%) and 31 (6.1%). Highest persistence were observed for HPV 35 (62.5%) and 52 (25%). New HPV acquisition rate was 5.6/1000 person-months of observation (PMO), highest for HPV 16 (1.1/1000 PMO). Type-specific clearance rates ranged between 2.9-5.5/100 PMO. HPV 16 and/or 18 infections were 41% (95% CI 4-63%) lower among women with 2-<3 years between marriage and first cervical sample collection compared to those with <2 years. HPV prevalence and acquisition rates in young Indian women were lower than their Western counterparts. HPV 16 infections being most common shows the importance and potential impact of HPV vaccination in India. Women with 2-3 years exposure had reduced risk possibly due to higher infections clearance.


Asunto(s)
Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Conducta Sexual , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , India/epidemiología , Estudios Longitudinales , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Prevalencia , Adulto Joven
8.
Zhonghua Fu Chan Ke Za Zhi ; 55(11): 784-790, 2020 Nov 25.
Artículo en Chino | MEDLINE | ID: mdl-33228350

RESUMEN

Objective: To evaluate the value of p16INK4a detected by p16INK4a immunostaining as a new generation of cervical cytology for primary screening and secondary screening in population-based cervical cancer screening, and in improving cytological diagnosis. Methods: Between 2016 and 2018, 5 747 non-pregnant women aged 25-65 years with sexual history were recruited and underwent cervical cancer screening via high-risk (HR)-HPV/liquid-based cytological test (LCT) test in Shenzhen and surrounding areas. All slides were immuno-stained using p16INK4a technology, among them, 902 cases were offered p16INK4a detection during primary screening, and the remaining 4 845 cases were called-back by the virtue of abnormal HR-HPV and LCT results for p16INK4a staining. Participants with complete LCT examination, HR-HPV test, p16INK4a staining and histopathological examination results were included in this study. The performance of p16INK4a in primary and secondary screening, and in assisting cytology to detect high grade squamous intraepithelial lesion [HSIL, including cervical intraepithelial neoplasia (CIN) Ⅱ or Ⅲ] or worse [HSIL (CIN Ⅱ)+ or HSIL (CIN Ⅲ)+] were analyzed. Results: (1) One-thousand and ninety-seven cases with complete data of p16INK4a and histology were included. Pathological diagnosis: 995 cases of normal cervix, 37 cases of low grade squamous intraepithelial lesion (LSIL), 64 cases of HSIL and one case of cervical cancer were found. Among them, 65 cases of HSIL (CIN Ⅱ)+ and 34 cases of HSIL (CIN Ⅲ)+ were detected. The positive rate of p16INK4a in HSIL (CIN Ⅱ)+ was higher than that in CINⅠ or normal pathology (89.2% vs 10.2%; P<0.01). (2) p16INK4a as primary screening for HSIL (CIN Ⅱ)+ or HSIL (CIN Ⅲ)+ was equally sensitive to primary HR-HPV screening (89.2% vs 95.4%, 94.1% vs 94.1%; P>0.05), but more specific than HR-HPV screening (89.8% vs 82.5%, 87.7% vs 80.2%; P<0.05). p16INK4a was equally sensitive and similarly specific to cytology (≥LSIL; P>0.05). (3) The specificity of LCT adjunctive p16INK4a for detecting HSIL (CIN Ⅱ)+ or HSIL (CIN Ⅲ)+ were higher than that of LCT alone or adjunctive HR-HPV (P<0.01), while the sensitivity were similar (P>0.05). (4) p16INK4a staining as secondary screening: p16INK4a was significantly more specific (94.1% vs 89.7%, 91.9% vs 87.4%; P<0.01) and comparably sensitive (84.6% vs 90.8%, 88.2% vs 91.2%; P>0.05) to cytology for triaging primary HR-HPV screening. HPV 16/18 to colposcopy and triage other HR-HPV with p16INK4a was equally sensitive (88.2% vs 94.1%; P=0.500) and more specific (88.3% vs 83.0%; P<0.01) than HPV 16/18 to colposcopy and triage other HR-HPV with LCT≥ atypical squamous cells of undetermined significance (ASCUS), and the referral rate decreased (14.0% vs 19.4%; P=0.005). Conclusions: For primary screening, p16INK4a is equally specific to cytology and equally sensitive to HR-HPV screening. p16INK4a alone could be an efficient triage after primary HR-HPV screening. In addition, p16INK4a immunostaining could be used as an ancillary tool to cervical cytological diagnosis, and improves its accuracy in cervical cancer screening.


Asunto(s)
Neoplasia Intraepitelial Cervical/diagnóstico , Inhibidor p16 de la Quinasa Dependiente de Ciclina/análisis , Inhibidor p16 de la Quinasa Dependiente de Ciclina/inmunología , Detección Precoz del Cáncer/métodos , Inmunohistoquímica/métodos , Infecciones por Papillomavirus/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Anciano , Biomarcadores de Tumor/análisis , Neoplasia Intraepitelial Cervical/metabolismo , Neoplasia Intraepitelial Cervical/virología , Inhibidor p16 de la Quinasa Dependiente de Ciclina/fisiología , Detección Precoz del Cáncer/estadística & datos numéricos , Femenino , Papillomavirus Humano 16 , Papillomavirus Humano 18 , Humanos , Persona de Mediana Edad , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/metabolismo , Infecciones por Papillomavirus/virología , Embarazo , Sensibilidad y Especificidad , Neoplasias del Cuello Uterino/metabolismo , Neoplasias del Cuello Uterino/virología , Frotis Vaginal
9.
Zhonghua Fu Chan Ke Za Zhi ; 55(10): 708-715, 2020 Oct 25.
Artículo en Chino | MEDLINE | ID: mdl-33120484

RESUMEN

Objective: Evaluation of the clinical value of the BioPerfectus multiplex real time (BMRT)-HPV for cervical cancer screening. Methods: Physician-collected specimens of 1 495 women who were positive of Cobas 4800 HPV (Cobas-HPV), HPV genotyping based on SEQ uencing (SEQ-HPV), and (or) cytology ≥low grade squamous intraepithelial lesion (LSIL) in the primary screening of Chinese Multiple-center Screening Trial (CHIMUST), and 2 990 women selected from those who were negative of primary screening in the same project through nested control randomization with age-matching were tested for BMRT-HPV, which reported type-specific viral loads/10 000 cells in each specimen. With comparing to Cobas-HPV results and taking cervical histopathological diagnosis as the endpoint, the concordance of high-risk (HR)-HPV subtypes among the three assays was explored ,and the sensitivity and specificity of BMRT-HPV for cervical cancer screening were evaluated. Results: (1) The overall agreenment of HR-HPV subtypes between BMRT-HPV and Cobas-HPV, or SEQ-HPV test sample was 94.8%, 94.4%, with Kappa values 0.827, 0.814. (2) The sensitivity and specificity for cervical intraepithelial neoplasia (CIN) Ⅱ+ of BMRT-HPV, Cobas-HPV and SEQ-HPV were 92.62%, 94.26%, 93.44% and 84.67%, 83.25%, 82.76%, respectively. There were no significant difference in sensitivity among the three HPV assays (all P>0.05), but the specificity of BMRT-HPV for CIN Ⅱ+ was higher than those of Cobas-HPV and SEQ-HPV (P<0.01). The sensitivity for CIN Ⅲ+ of three HPV assays were all 100.00%, and the specificity for CIN Ⅲ+ of BMRT-HPV was higher than those of Cobas-HPV and SEQ-HPV (83.40% vs 81.95%, 83.40% vs 81.50%; P<0.01). The number of pathological examinations of colposcopy for cervical biopsy detected in 1 case of CIN Ⅱ+ or CIN Ⅲ+ in BMRT-HPV was less than those in Cobas-HPV and SEQ-HPV (P<0.01). When using HPV 16/18 + cytology ≥atypical squamous cell of undetermined signification (ASCUS) to triage HPV positive women among three assays, there was no different in the sensitivities of detecting CIN Ⅱ+ and CIN Ⅲ+ (P>0.05). The specificity BMRT-HPV was slightly higher than those in Cobas-HPV or SEQ-HPV (all P<0.05), and the colposcopy referral rate was lower than those in Cobas-HPV and SEQ-HPV (all P<0.05). Conclusions: BMRT-HPV is as sensitive as Cobas-HPV or SEQ-HPV for primary cervical cancer screening, and has higher specificity. Therefore it could be used as a primary screening method for cervical cancer, which is worthy of clinical application.


Asunto(s)
Neoplasia Intraepitelial Cervical/diagnóstico , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Neoplasia Intraepitelial Cervical/virología , ADN Viral/análisis , ADN Viral/genética , Detección Precoz del Cáncer , Femenino , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Humanos , Tamizaje Masivo/métodos , Papillomaviridae/genética , Infecciones por Papillomavirus/virología , Valor Predictivo de las Pruebas , Embarazo , Sensibilidad y Especificidad , Neoplasias del Cuello Uterino/virología , Frotis Vaginal/métodos
10.
J Exp Clin Cancer Res ; 39(1): 200, 2020 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-32967703

RESUMEN

BACKGROUND: SARS-coronavirus-2 enters host cells through binding of the Spike protein to ACE2 receptor and subsequent S priming by the TMPRSS2 protease. We aim to assess differences in both ACE2 and TMPRSS2 expression in normal tissues from oral cavity, pharynx, larynx and lung tissues as well as neoplastic tissues from the same areas. METHODS: The study has been conducted using the TCGA and the Regina Elena Institute databases and validated by experimental model in HNSCC cells. We also included data from one COVID19 patient who went under surgery for HNSCC. RESULTS: TMPRSS2 expression in HNSCC was significantly reduced compared to the normal tissues. It was more evident in women than in men, in TP53 mutated versus wild TP53 tumors, in HPV negative patients compared to HPV positive counterparts. Functionally, we modeled the multivariate effect of TP53, HPV, and other inherent variables on TMPRSS2. All variables had a statistically significant independent effect on TMPRSS2. In particular, in tumor tissues, HPV negative, TP53 mutated status and elevated TP53-dependent Myc-target genes were associated with low TMPRSS2 expression. The further analysis of both TCGA and our institutional HNSCC datasets identified a signature anti-correlated to TMPRSS2. As proof-of-principle we also validated the anti-correlation between microRNAs and TMPRSS2 expression in a SARS-CoV-2 positive HNSCC patient tissues Finally, we did not find TMPRSS2 promoter methylation. CONCLUSIONS: Collectively, these findings suggest that tumoral tissues, herein exemplified by HNSCC and lung cancers might be more resistant to SARS-CoV-2 infection due to reduced expression of TMPRSS2. These observations may help to better assess the frailty of SARS-CoV-2 positive cancer patients.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Neoplasias de Cabeza y Cuello/patología , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Neumonía Viral/complicaciones , Serina Endopeptidasas/metabolismo , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Estudios de Casos y Controles , Infecciones por Coronavirus/virología , Femenino , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/metabolismo , Neoplasias de Cabeza y Cuello/virología , Humanos , Masculino , Pandemias , Infecciones por Papillomavirus/virología , Neumonía Viral/virología , Pronóstico , Carcinoma de Células Escamosas de Cabeza y Cuello/metabolismo , Carcinoma de Células Escamosas de Cabeza y Cuello/virología , Tasa de Supervivencia
11.
Medicine (Baltimore) ; 99(38): e22320, 2020 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-32957398

RESUMEN

Cervical cancer is a serious global health problem. The objective of this study was to provide a suitable cytology-based cervical screening method in women of different ages in primary hospitals.This study was a retrospective cohort study that included 9765 women who underwent primary cytology-based cervical screening and were grouped by age (35-44, 45-54, and 55-64 years old). Patients with abnormal cytology on the primary cervical thin-prep cytologic test (TCT) were advised to undergo triage human papillomavirus (HPV) test. Furthermore, patients with positive outcomes of the 2 indices underwent cervical tissue biopsy. The positive rate of TCT and HPV was compared among the 3 defined age groups. The sensitivity, specificity, and positive predictive value of TCT and HPV were assessed.In total, 2.5% (241/9765) of women had atypical squamous cells of undetermined significance or worse by TCT. High-risk (HR)-HPV infection was found in 70 triage participants. Neoplastic changes were confirmed in 95 patients (95/437, 21.7%) by biopsies. Among the different age groups, the positive rate of abnormal cytology was significantly different (P = .003), and the positive rate of HR-HPV was similar (P = .299). The sensitivity of initial TCT testing to detect intraepithelial neoplasia was higher than that of triage HPV testing, whereas the specificity, the positive predictive value of triage HPV testing was higher than that of TCT. The Youden index of HPV testing was higher than that of TCT detection in the 3 age groups, namely 0.582 versus 0.432, 0.553 versus 0.228, and 0.416 versus 0.332, respectively.The results of this study indicate that TCT testing is suitable as a cervical cancer screening method for women ≥35 years old in primary hospitals. Triage testing for women with HR-HPV has a high negative predictive value, reduces the rate of misdiagnosis, seems to be an excellent triage method for repeat atypical squamous cells of undetermined significance, and reduces the number of referral colposcopies preventing unnecessary overtreatment. The results of this study provide a crucial foundation for a unified guideline cervical cancer screening for primary health care institutions.


Asunto(s)
Detección Precoz del Cáncer/métodos , Infecciones por Papillomavirus/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Adulto , Distribución por Edad , China , Femenino , Humanos , Tamizaje Masivo , Persona de Mediana Edad , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/virología , Estudios Retrospectivos , Neoplasias del Cuello Uterino/virología
12.
Obstet Gynecol ; 136(4): 663-665, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32925610

RESUMEN

Multiple studies suggest that health care workers treating human papillomavirus (HPV)-associated conditions may experience occupational exposure to the virus. Case reports describe the development of cancer and other disease in health care professionals at low risk for such conditions except for their work. Despite limited data, vaccination can be a safe and effective method to reduce this uncertain risk. We argue that health care workers, including physicians, nurses, and others, who participate in the treatment of HPV-associated disease should consider vaccination.


Asunto(s)
Personal de Salud , Exposición Profesional , Neoplasias Orofaríngeas , Papillomaviridae , Infecciones por Papillomavirus , Actitud del Personal de Salud , Procedimientos Quirúrgicos Ginecológicos/efectos adversos , Procedimientos Quirúrgicos Ginecológicos/métodos , Conocimientos, Actitudes y Práctica en Salud , Humanos , Exposición Profesional/efectos adversos , Exposición Profesional/análisis , Exposición Profesional/prevención & control , Virus Oncogénicos , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/prevención & control , Neoplasias Orofaríngeas/virología , Papillomaviridae/aislamiento & purificación , Papillomaviridae/patogenicidad , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/virología , Vacunas contra Papillomavirus/uso terapéutico , Vacunación/métodos
13.
Artículo en Inglés | MEDLINE | ID: mdl-32867315

RESUMEN

Background: Cervical cancer is one of the most common cancers in women and about 90% of cervical cancer can be reduced by regular screening. The Pap smear has been well in place as a primary cervical screening method since 1950s; however, coverage is still not optimal. This study explored the feasibility of HPV self-sampling in two under-screened population groups in Hong Kong (HK): never screened and not regularly screened females, to estimate the uptake rate and preference rate in the future. Materials and Methods: This was a cross-sectional study to explore the acceptability and feasibility of HPV self-sampling in two age groups: aged 25-35 and aged ≥45, which were reported as the highest proportion of the under-screened population in HK between 2017 and 2018. The study invited eligible women from an HPV study cohort to perform HPV self-sampling at home by themselves. The number of specimens returned from participants was recorded and used to determine the feasibility of HPV self-sampling in the community. The participants were asked to fill in the questionnaires before and after HPV self-sampling to indicate their attitudes, acceptability, and future preference for HPV self-sampling as an acceptable alternative primary cervical cancer screening method. Results: A total of 177 subjects participated in the present study and have achieved a good overall uptake rate of 73% (129/177) who returned the self-collected cervicovaginal sample for HPV testing. Among the under-screened population, there was a higher response rate in aged ≥45 than those aged 25-35. The findings also revealed that women who were under-screened, including those who have never been screened, were more likely to prefer HPV self-sampling than those who had regular screening. This study found that the acceptability of HPV self-sampling was fairly positive among the respondents. The findings also indicated that HPV self-sampling was not only beneficial to enhance their health awareness but also to promote the cervical cancer screening uptake rate, especially among the under-screened or never screened populations. Conclusions: HPV self-sampling would be a solution to overcome the perceived barriers in clinician-based screening. The findings also indicated that it could be feasible to use as an alternative primary cervical cancer screening.


Asunto(s)
Tamizaje Masivo/métodos , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Aceptación de la Atención de Salud , Grupos de Población/estadística & datos numéricos , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Adulto , Estudios Transversales , Detección Precoz del Cáncer , Estudios de Factibilidad , Femenino , Hong Kong/epidemiología , Humanos , Área sin Atención Médica , Persona de Mediana Edad , Infecciones por Papillomavirus/etnología , Aceptación de la Atención de Salud/etnología , Prioridad del Paciente , Autocuidado , Manejo de Especímenes , Neoplasias del Cuello Uterino/etnología , Frotis Vaginal , Salud de la Mujer
14.
Arch Virol ; 165(11): 2633-2640, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32812092

RESUMEN

Our aim was to analyze the prevalence of high-risk human papillomavirus (HR-HPV) and its association with risk factors related to cervical lesions. We used 362 cervical samples from a transversal study to detect nineteen types from the high-risk HPV clade by highly sensitive PCR. Unexpectedly, we found a very high prevalence of HPV type 66 (32.8%), particularly in low-grade squamous intraepithelial lesions. A significant association of HPV66 with previously sexually transmitted disease was observed (p < 0.05). Our results strongly suggest that HPV66 might be indicative of cervical lesions that will not progress to cancer. HPV genotyping by methods that grouped type 66 with other HR-HPV clade types should be interpreted with caution.


Asunto(s)
Neoplasia Intraepitelial Cervical/virología , Cuello del Útero/virología , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasia Intraepitelial Cervical/patología , Detección Precoz del Cáncer , Femenino , Genotipo , Técnicas de Genotipaje , Humanos , Modelos Logísticos , México/epidemiología , Persona de Mediana Edad , Papillomaviridae/clasificación , Factores de Riesgo , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/virología , Frotis Vaginal , Adulto Joven
15.
PLoS Pathog ; 16(8): e1008792, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32813746

RESUMEN

Tumor suppressors can exert pro-proliferation functions in specific contexts. In the beta human papillomavirus type 38 (HPV38) experimental model, the viral proteins E6 and E7 promote accumulation of a wild-type (WT) p53 form in human keratinocytes (HKs), promoting cellular proliferation. Inactivation of p53 by different means strongly decreases the proliferation of HPV38 E6/E7 HKs. This p53 form is phosphorylated at S392 by the double-stranded RNA-dependent protein kinase PKR, which is highly activated by HPV38. PKR-mediated S392 p53 phosphorylation promotes the formation of a p53/DNMT1 complex, which inhibits expression of integrin alpha 1 (ITGA1), a repressor of epidermal growth factor receptor (EGFR) signaling. Ectopic expression of ITGA1 in HPV38 E6/E7 HKs promotes EGFR degradation, inhibition of cellular proliferation, and cellular death. Itga1 expression was also inhibited in the skin of HPV38 transgenic mice that have an elevated susceptibility to UV-induced skin carcinogenesis. In summary, these findings reveal the existence of a specific WT p53 form that displays pro-proliferation properties.


Asunto(s)
Proteínas Portadoras/antagonistas & inhibidores , Proliferación Celular , Queratinocitos/patología , Proteínas de la Membrana/antagonistas & inhibidores , Proteínas Oncogénicas Virales/metabolismo , Proteínas E7 de Papillomavirus/metabolismo , Infecciones por Papillomavirus/complicaciones , Proteínas Represoras/metabolismo , Neoplasias Cutáneas/etiología , Proteína p53 Supresora de Tumor/metabolismo , Animales , Células Cultivadas , Regulación hacia Abajo , Humanos , Queratinocitos/inmunología , Queratinocitos/virología , Ratones , Ratones Transgénicos , Proteínas Oncogénicas Virales/genética , Papillomaviridae/aislamiento & purificación , Proteínas E7 de Papillomavirus/genética , Infecciones por Papillomavirus/virología , Proteínas Represoras/genética , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/patología , Proteína p53 Supresora de Tumor/genética
16.
PLoS One ; 15(8): e0237988, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32853216

RESUMEN

OBJECTIVE: To evaluate the 9-year incidence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and cumulative adherence to perform a next test in a cohort of women aged 40+ years with no cervical screening cytology within a window of 5 years (underscreened women), after baseline cervical cytology and HPV tests. METHODS: In Catalonia, Spain, co-testing with cytology and HPV test has been recommended in the Public Health system since 2006 for underscreened women. In 2007, 1,594 women with underscreened criteria were identified and followed through medical records form Pathological Department. 9-year cumulative incidence of histologically confirmed CIN2+ and cumulative adherence to perform a next test were estimated using Kaplan-Meier statistics. RESULTS: Follow-up was available for 1,009 women (63.3%) resulting in 23 women with. CIN2+ (2.3%). Of them, 4 women (17%) had both tests negative at baseline (3CIN2 and 1CIN3) with cumulative incidence of CIN2+ of 0.4% (95% CI: 0.1-1.4) at 5-years and 1.3% (95% CI: 0.4-3.7) at 9-years. During the first year, the prevalence among women with both tests positive was 27.0% (95% CI: 13.0-50.6) for CIN2+. Lost to follow-up was higher among women with both tests negative compared to those with both positive tests (38.7% vs 4.2%, p-value <0.001). 40.5% of the women HPV-/cyto- had a re-screening test during the 4 years following the baseline, increasing until 53.5% during the 6 years of follow-up. CONCLUSIONS: HPV detection shows a high longitudinal predictive value at 9-year to identify women at risk to develop CIN2+. The data validate a safe extension of the 3-year screening intervals (current screening interval) to 5-year intervals in underscreened women that had negative HPV result at baseline. It is necessary to establish mechanisms to ensure screening participation and adequate follow-up for these women.


Asunto(s)
Tamizaje Masivo , Papillomaviridae/aislamiento & purificación , Neoplasias del Cuello Uterino/virología , Anciano , Estudios de Cohortes , Detección Precoz del Cáncer , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Papillomaviridae/fisiología , Riesgo , Factores de Tiempo , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología
17.
Acta otorrinolaringol. esp ; 71(4): 212-218, jul.-ago. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-194985

RESUMEN

ANTECEDENTES Y OBJETIVO: Diferentes estudios realizados en poblaciones con una elevada incidencia de infección por HPV han encontrado una ausencia de capacidad pronóstica de la afectación ganglionar clínica (cN+) en los pacientes con carcinomas de orofaringe HPV-positivos. El objetivo del presente estudio fue evaluar la capacidad pronóstica de la afectación ganglionar en pacientes con carcinomas de orofaringe en función del estatus HPV en una población oncológica con una baja incidencia de infección por HPV. MATERIAL Y MÉTODOS: Estudio retrospectivo de una cohorte de 420 pacientes con carcinomas de orofaringe tratados durante el periodo 1990-2016 de los cuales se dispuso de información del estatus HPV. RESULTADOS: Un 14,8% de los pacientes incluidos en el estudio presentaron tumores HPV-positivos. En relación con los pacientes sin afectación ganglionar (cN0), la afectación ganglionar en el momento del diagnóstico (cN+) disminuyó de forma significativa la supervivencia específica de los pacientes con carcinomas de orofaringe HPV-negativos. Por el contrario, no aparecieron diferencias en la supervivencia para los pacientes con tumores HPV-positivos en función de la presencia de afectación ganglionar. El antecedente de consumo de tóxicos no modificó la ausencia de significado pronóstico de la afectación ganglionar para los pacientes con tumores HPV-positivos. CONCLUSIONES: La afectación regional en el momento del diagnóstico no es una variable con capacidad pronóstica para los pacientes con carcinomas de orofaringe HPV-positivos


BACKGROUND AND OBJECTIVE: Different studies performed in populations with a high incidence of HPV infection have found no prognostic capacity of clinical nodal involvement (cN+) in patients with HPV-positive oropharyngeal carcinomas. The objective of this study was to assess the prognostic ability of nodal involvement in patients with oropharyngeal carcinomas according to HPV status in a cancer population with a low incidence of HPV infection. MATERIAL AND METHODS: Retrospective study of a cohort of 420 patients with oropharyngeal carcinomas treated during the period 1990-2016 for whom information on HPV status was available. RESULTS: 14.8% of the patients included in the study had HPV-positive tumours. In relation to patients without nodal involvement (cN0), nodal involvement at diagnosis (cN+) significantly decreased the specific survival of patients with HPV-negative oropharyngeal carcinomas. Conversely, no differences in survival were found for patients with HPV-positive tumours according to the presence of nodal involvement. A history of toxic consumption did not change the absence of prognostic significance of nodal involvement for patients with HPV-positive tumours. CONCLUSIONS: Regional involvement at the time of diagnosis is not a prognostic variable for patients with HPV-positive oropharyngeal carcinomas


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Neoplasias Orofaríngeas/virología , Carcinoma/virología , Infecciones por Papillomavirus/complicaciones , Ganglios Linfáticos/virología , Estudios Retrospectivos , Neoplasias Orofaríngeas/patología , Carcinoma/patología , Infecciones por Papillomavirus/patología , Metástasis Linfática , Ganglios Linfáticos/patología , Supervivencia sin Enfermedad , Estimación de Kaplan-Meier , Papillomaviridae/aislamiento & purificación , Factores de Tiempo
18.
Ann Epidemiol ; 49: 36-41, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32711054

RESUMEN

PURPOSE: This study aimed to assess the association between body mass index and incident or persistent cervical high-risk human papillomavirus (hrHPV) infection. METHODS: This cohort study included 6809 women from the general Danish population who participated in two clinical visits (in 1991-1993 and in 1993-1995). Height and weight were measured by nurses, lifestyle data were obtained by structured interviews, and cervical cytology samples were obtained for hrHPV DNA testing. We conducted log-binomial regression to estimate risk ratios (RRs) with 95% confidence intervals (CIs) of incident and type-specific persistent hrHPV infection according to body mass index, adjusting for age, education, smoking, and the number of sexual partners in the past year. RESULTS: We found no increased risk of incident hrHPV infection in women who were underweight (RRadjusted, 0.97; 95% CI, 0.64-1.48), overweight (RRadjusted, 0.98, 95% CI, 0.82-1.17), or obese (RRadjusted, 0.93; 95% CI, 0.63-1.36) compared with women of normal weight. The risk of hrHPV persistence was similar in overweight (RRadjusted, 0.98; 95% CI, 0.71-1.34) and obese (RRadjusted, 1.00; 95% CI, 0.56-1.79) women compared with women of normal weight, whereas underweight women had a lower risk (RRadjusted, 0.32; 95% CI, 0.11-0.95). CONCLUSIONS: Overweight and obesity were not associated with HPV incidence or persistence when adjusting for sexual behavior.


Asunto(s)
Índice de Masa Corporal , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/epidemiología , Cuello del Útero/virología , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Adulto , Neoplasia Intraepitelial Cervical/virología , Estudios de Cohortes , Dinamarca/epidemiología , Femenino , Humanos , Incidencia , Tamizaje Masivo , Obesidad/epidemiología , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Papillomaviridae/genética , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/virología , Vigilancia de la Población , Delgadez/epidemiología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología
19.
BMC Womens Health ; 20(1): 139, 2020 07 02.
Artículo en Inglés | MEDLINE | ID: mdl-32615963

RESUMEN

BACKGROUND: Although human papillomavirus (HPV) infection has been regarded as the cause of cervical cancer in over 99% of cases, only a small fraction of HPV-infected women develop this malignancy. Emerging evidence suggests that alterations of mitochondrial DNA copy number (mtCN) may contribute to carcinogenesis. However, the relationship between mtCN and cervical cancer remains undetermined. METHODS: The current study included 591 cervical cancer cases and 373 cancer-free controls, all of whom were infected with high-risk HPV. Relative mtCN in cervical cancer exfoliated cells was measured by qRT-PCR assays, and logistic regression analysis was performed to compute odds ratios (ORs) and 95% confidence intervals (CIs). Interaction between mtCN and HPV types was assessed by using the Wald test in logistic regression models. RESULTS: HPV16, 18, 52, and 58 were the most common types in both case and control groups. Median mtCN in cases was significantly higher than that in controls (1.63 vs. 1.23, P = 0.03). After adjustment for age and HPV types, the highest quartile of mtCN was associated with increased odds of having cervical cancer (OR = 1.77, 95% CI = 1.19, 2.62; P < 0.01), as compared to the lowest quartile. A dose-response effect of mtCN on cervical cancer was also observed (Ptrend < 0.001). The interaction between mtCN and HPV types was statistically nonsignificant. CONCLUSIONS: In women who test HPV positive, the increase of mtCN in cervical exfoliated cells is associated with cervical cancer. This suggests a potential role of mtCN in cervical carcinogenesis.


Asunto(s)
Neoplasia Intraepitelial Cervical/diagnóstico , Variaciones en el Número de Copia de ADN , ADN Mitocondrial/genética , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Anciano , Estudios de Casos y Controles , Neoplasia Intraepitelial Cervical/epidemiología , China/epidemiología , ADN Viral/genética , Femenino , Humanos , Persona de Mediana Edad , Papillomaviridae/clasificación , Infecciones por Papillomavirus/epidemiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores de Riesgo , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/virología
20.
J Laryngol Otol ; 134(6): 533-540, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32616096

RESUMEN

OBJECTIVE: To evaluate the effect of definitive radiotherapy dose on survival in patients with human papillomavirus positive oropharyngeal carcinoma. METHODS: Human papillomavirus positive oropharyngeal carcinoma patients staged T1-3 and N0-2c, who received definitive radiotherapy (fraction sizes of 180 cGy to less than 220 cGy), were identified from the National Cancer Database 2010-2014 and stratified by radiation dose (50 Gy to less than 66 Gy, or 66 Gy or more). RESULTS: A total of 2173 patients were included, of whom 124 (6 per cent) received a radiation dose of 50 Gy to less than 66 Gy. With a median follow up of 33.8 months, patients had a 3-year overall survival rate of 88.6 per cent (95 per cent confidence interval = 87.1-90.1 per cent). On multivariate Cox analysis, a radiotherapy dose of 50 Gy to less than 66 Gy (hazard ratio = 0.95, 95 per cent confidence interval = 0.52-1.74, p = 0.86) was not a predictor of increased mortality risk. CONCLUSION: Human papillomavirus positive oropharyngeal carcinoma patients had excellent outcomes with definitive radiotherapy doses of 50 Gy to less than 66 Gy. These results further support patients enrolling into clinical trials for radiation dose de-escalation.


Asunto(s)
Carcinoma/radioterapia , Neoplasias Orofaríngeas/mortalidad , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma/virología , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Orofaríngeas/patología , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/patología , Radioterapia/métodos , Tasa de Supervivencia
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