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Cervical Intraepithelial Neoplasia/*virology ; Female ; Humans ; *Papillomaviridae ; Papillomavirus Infections ; Uterine Cervical Dysplasia ; Uterine Cervical Neoplasms/virology

Cervical Intraepithelial Neoplasia ; diagnosis ; pathology ; virology ; China ; DNA Probes, HPV ; Female ; Humans ; Pregnancy ; Vaginal Smears ; methods

OBJECTIVETo investigate the prevalence of physical state of HPV-16 DNA in cervical cancer and cervical precancerous carcinoma.

METHODSMultiplex PCR was adopted to detect the physical state of HPV in samples from 252 patients with cervical carcinoma, including 48 samples of cervical cancer, 204 cervical intraepithelial neoplasia (CIN ) (125 CIN I, 46 CIN II and 33 CIN III) and 20 normal samples from the subjects with hysteromyoma undergoing hysterectomy, respectively.

RESULTSAmong 48 patients with cervical cancer, 31 (65.6%) were infected with HPV-16. Eighteen among 31 (58.1%) HPV-16 infected patients with cervical cancer were found to have integrated infection of HPV-16. The positive rates of HPV-16 infection in the patients with CIN I, CIN II and CIN III were 19.2%, 34.8% and 42.4%, and the integrated infection rates of HPV-16 were 16.7%, 18.8% and 35.7%, respectively. Compared with patients with different grades of CIN, the integrated rate of HPV-16 infection in those with cervical cancer was significantly elevated.

CONCLUSIONAmong the patients with HPV-16 infection, the integrated state of HPV-16 is positively correlated with the severity of cervical lesions. Combined HPV typing test and detection of integrated viral state contribute to predicting the prognosis of patients with cervical precancerous lesions and increasing the accuracy of screening cervical cancer on the basis of HPV DNA detection.

Cervical Intraepithelial Neoplasia ; virology ; DNA, Viral ; Early Detection of Cancer ; Female ; Human papillomavirus 16 ; physiology ; Humans ; Papillomavirus Infections ; virology ; Uterine Cervical Neoplasms ; virology ; Virus Integration

BACKGROUNDCervical cancer is the second most common cause of death from cancer among women worldwide. Human papillomavirus (HPV) plays a central role in the etiology of cervical cancer. It is important to describe the prevalence of HPV infection in different types of cervical lesions and to explore the relation between HPV viral load and the severity of cervical lesions.

METHODSTo describe the HPV infection prevalence and viral load in different age groups, we retrospectively investigated 6405 cases of women who were organized by their units to take health-examination. They were given Hybrid Capture II tests between January 2005 and December 2006. The correlation between HPV viral load and pathology was assessed.

RESULTSOverall HPV infection prevalence was 29.1% (1864/6405), while in women 18-20 years old it was 54.4% (31/57), the highest among all age groups. After declining rapidly, HPV prevalence stabilized at about 30.0% in women aged 30 and older. Of the 6405 women, 1483 women had a colposcopic biopsy and 33.2% (492/1483) were positive for HPV DNA. Twenty-one percent of women with a normal diagnosis (238/1095) had HPV infection, a statistically significantly lower prevalence than in women with cervical lesions, including those with cervical intraepithelial neoplasia (68.8% in CIN1, 66.7% in CIN2, and 76.5% in CIN3) or with cervical cancer (94.1%). The correlation coefficient between viral load and cervical lesion severity was 0.134, which was not statistically significant (P = 0.075). Viral load values in women with CINs and cervical cancer were calculated, and no significant differences were identified.

CONCLUSIONSThe prevalence of high-risk HPV infection among women attending hospitals for health-examination in Shanghai is similar to the worldwide rate. HPV viral load can distinguish cervical lesions from normal individuals but cannot adequately predict the severity of cervical lesions.

Adolescent ; Adult ; Aged ; Cervical Intraepithelial Neoplasia ; virology ; DNA, Viral ; analysis ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; epidemiology ; Uterine Cervical Neoplasms ; virology ; Viral Load

Cervical cancer is the most common malignancy of the female genital tract. Its incidence is still increasing with lower average onset age. Mass screening should be above prevention and treatment, and three screening programs, including the optimal program, the general program, and the basic program, are currently adopted in China. Cervical intraepithelial neoplasia (CIN) , a precancerous lesion, can be confirmed by the combined use of cytology, colposcopy, and histology and then managed with standardized approach. Human papillomavirus (HPV) infection is an essential factor during the development of cervical cancer, and persistent infection of high-risk HPVs may lead to CIN and subsequently develop to cervical cancer. High-risk HPV detection can be used for screening, differentiation of the atypical squamous cells of undetermined significance/ low-grade squamous intraepithelial lesion (ASCUS/LSIL) triage, and follow-up after treatment. The modern strategy of HPV infection is "to treat the disease, CIN, means to treat the virus, HPV". The licensing of HPV vaccine is an important event in cancer prevention, and this vaccine can be used for the primary prevention. However, early diagnosis and early treatment are still the most basic strategies for cervical cancer prevention and treatment.
Cervical Intraepithelial Neoplasia ; diagnosis ; therapy ; virology ; Early Diagnosis ; Female ; Humans ; Papillomavirus Infections ; diagnosis ; prevention & control ; therapy ; Papillomavirus Vaccines ; Uterine Cervical Neoplasms ; diagnosis ; prevention & control ; virology

OBJECTIVETo analyse the infection of high-risk human papiliomavirus (HR-HPV) in cervical lesion wome, and evaluate the significance of high-risk human pappilomavirus detection by hybrid capture II (HV-II) in screening and diagnosing cervical lesion, especially high grade cervical intraepithelial neoplasia (CIN).

METHODSA series of 1130 patients of cervical lesion were preliminarily diagnosed by cervical cytological examination, HR-HPV detection by HC-II , colposcopy and biopsy under the colposcopy between June 2009 and December 2008, including 212 CIN I and (or) condyloma (CIN I/HPV I), 442 CIN II/III, 28 invasive cervical cancer. cervical cytological examination is by thin prep liquid-based cytology test(TCT),and HR-HPV detection is by HC-II.

RESULTSIn 1130 cases the positive of HR-HPV was 65.84% (744/1130). Unusual cytology result were 862 cases, with 356 ASCUS, 84 ASCH, 216 LSIL, 184HSIL and 22 cancer. The number of biopsy > or = CINI/HPVI was 682, positive rate of HR-HPV was 78.59% (536/682). In screening CIN II or above, sensitivity, specificity, PPV and NPV of TCT were 88.94%, 32.73%, 48.49%, 80.60%, of HR-HPV DNA detectiort by HC-II were 90.21%, 51.82%, 57.14%, 88.14%, and of HR-HPV detection combined with cytology were 97.45%, 22.42%, 47.22%, 92.50%.

CONCLUSIONThe infection rate of HR-HPV in cervical lesions is higher in each age group. Infection rate of HR-HPV is ascending with serious degree of cervical lesion. HR-HPV detection by HC- II is an important method in screening cervical lesion. HR-HPV detection is a viable option in the management of women with ASCUS and LSIL of TCT, with higher sensitivity and NPV.

Adult ; Aged ; Cervical Intraepithelial Neoplasia ; virology ; China ; Female ; Humans ; Middle Aged ; Papillomaviridae ; isolation & purification ; Retrospective Studies ; Risk ; Uterine Cervical Neoplasms ; virology

OBJECTIVETo define a correlation between different human papillomavirus (HPV) types and telomerase activity in cervical cancer.

METHODSTelomerase activity was detected by TRAP-PCR, and different HPV type was determined by PCR in 83 cervical cancer, 47 cervical intraepithelial neoplasia (CIN) and 10 normal cervix cases.

RESULTSWith regard to positive rates of telomerase and HPV 16/18: the results were cervical cancer > CIN > normal cervix, CIN III > CIN I, II; with regard to HPV 6/11 positive rate: the results showed CIN I, II > CIN III. Positive rates of telomerase cervical cancer and HPV were bearing on grading and staging, but they did not correlate with histologic subtypes. Positive rate of HPV 6/11 had nothing to do with grading, staging and histologic patterns. On expression strength of telomerase and HPV 16/18: the results showed cervical cancer > CIN, CIN III > CIN I, II. Regard to HPV 6/11'expression strength: the results showed CIN I, II > CIN III, CIN > cervical carcinoma.

CONCLUSIONHPV 16/18 infection seemed to have played an important role in carcinogenesis of cervical lesions by activation of telomerase.

Cervical Intraepithelial Neoplasia ; enzymology ; pathology ; virology ; Female ; Humans ; Neoplasm Staging ; Papillomaviridae ; isolation & purification ; Telomerase ; metabolism ; Uterine Cervical Neoplasms ; enzymology ; pathology ; virology

OBJECTIVE: To investigate the expression of claudin 4 (CLDN4) in cervical tissues from patients with different cervical lesions, and to explore the value of combined detection of CLDN4 and high risk human papilloma virus (HR-HPV). METHODS: The cervical tissue specimens of low-grade squamous intraepithelial lesion (LSIL, =30), high-grade squamous intraepithelial lesion (HSIL, =30), squamous cell carcinoma (SCC, =30) as well as chronic cervicitis (control, =30) were collected from the Sir Run Run Shaw Hospital of Zhejiang University during June 2015 and December 2016. The expression of CLDN4 protein in tissue specimens was detected by immunohistochemistry, HR-HPV was detected by real-time quantitative PCR, and the cervical exfoliated cells were examined by thinprep cytologic test (TCT). The ROC curve was applied to analyze the diagnostic value of TCT combined with HR-HPV and CLDN4 combined with HR-HPV tests for HSIL and SCC of the cervix. RESULTS: With the increase of the severity of cervical lesions, the positive rate of CLDN4 expression rose (=0.832, <0.05). Positivity of both HR-HPV infection and CLDN4 expression was found mainly in the HSIL and SCC groups. The areas under curve (AUC) of TCT combined with HR-HPV and CLDN4 combined with HR-HPV tests for diagnosis of HSIL and SCC were 0.683 and 0.633, respectively; the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TCT combined with HR-HPV test for diagnosis of HSIL and SCC were 100.0%, 36.7%, 61.2%, 100.0% and 46.7% respectively; those of CLDN4 combined with HR-HPV test were 96.7%, 30.0%, 58.0%, 90.0% and 55.0%, respectively. CONCLUSIONS CLDN4 expression may be related to the occurrence and development of cervical carcinoma and precancerous lesions. CLDN4 combined with HR-HPV test may be used for diagnosis of HSIL and SCC of the cervix clinically.
Carcinoma, Squamous Cell ; diagnosis ; virology ; Cervical Intraepithelial Neoplasia ; diagnosis ; virology ; Claudin-4 ; genetics ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Immunochemistry ; Papillomaviridae ; isolation & purification ; Real-Time Polymerase Chain Reaction ; Squamous Intraepithelial Lesions of the Cervix ; virology ; Uterine Cervical Neoplasms ; diagnosis

Human papillomavirus (HPV) infection is very common but with limited therapies available. Although the prophylactic vaccination will be promoted worldwide soon, it can only show its benefits decades later. For individuals who already have established infections and dysplasias, it has little efficacy. In contrast, the therapeutic vaccines bridge the temporal deficit by fighting against the established HPV infections and HPV-related diseases. HPV oncogenes may be delivered in viral and bacterial vectors, in peptides or protein, in nucleic acid form, or in cell-based vaccines. This review summarizes the clinical trials of HPV therapeutic vaccines under the way and the different preclinical research strategies that are under investigations.
Animals ; Cancer Vaccines ; therapeutic use ; Cervical Intraepithelial Neoplasia ; therapy ; virology ; Condylomata Acuminata ; therapy ; virology ; Female ; Humans ; Papillomavirus Infections ; prevention & control ; therapy ; Papillomavirus Vaccines ; therapeutic use ; Uterine Cervical Diseases ; therapy ; virology ; Uterine Cervical Neoplasms ; therapy ; virology

OBJECTIVETo evaluate the diagnostic performance of different specimens for detecting CIN2(+), and to find the solution of the problem that why the performance of self-collected specimen is worse than cervical specimen collected by physician.

METHODSThe cervix, lower 1/3 vagina, upper 1/3 vagina and self-collected specimens from each of the 806 women who took part in this multi-center screening program from May 2006 to April 2007 were tested by hybrid capture 2 (HC2) technique. The diagnostic performance of HC2 on the four specimens for detecting CIN2(+) lesions was calculated. Linear array was performed on the four specimens from 489 out of the 806 women and the diagnostic performance of linear array on the four specimens for detecting CIN2(+) lesions was also calculated. Z test was used to compare the area under ROC and McNemar or χ(2) test was used to compare the sensitivity and specificity of different specimens.

RESULTSThe area under ROC of the cervix, 1/3 upper vagina, 1/3 lower vagina and self-collected samples testing by HC2 for detecting CIN2(+) lesions were 0.902, 0.793, 0.769 and 0.773, respectively (P < 0.001). Using 1 RUL/CO as the cut-point of HC2, the sensitivity of the cervix, upper vagina, lower vagina and self-collected samples were 98.0%, 91.8%, 83.7% and 81.6%. Compared with the cervical specimen, the sensitivity of self-collected specimen for detecting CIN2(+) lesions was significantly lower (P = 0.008). Lowering the cutoff value for HC2 test could improve the sensitivity of self-collected specimen, but it significantly compromised the specificity. The sensitivity of self-collected specimen tested by linear array for detecting CIN2(+) lesions was 95.7% and it was not significantly different compared with the sensitivity of cervical specimen (97.9%) tested by HC2.

CONCLUSIONSThe performance of self-collected specimen tested by HC2 for detecting CIN2(+) lesions is lower than that of physician-collected cervical specimen, and lowering the cutoff value can't improve its diagnostic performance. Using linear array as the HPV DNA test can significantly improve the screening diagnostic performance of self-collected specimens.

Adolescent ; Cervical Intraepithelial Neoplasia ; diagnosis ; virology ; Cervix Uteri ; virology ; DNA, Viral ; analysis ; Female ; Human Papillomavirus DNA Tests ; Humans ; Mass Screening ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; diagnosis ; virology ; Self-Examination ; Specimen Handling ; methods ; Uterine Cervical Neoplasms ; diagnosis ; virology ; Vagina ; virology