OBJECTIVETo explore the distribution the tyes- of human papillomavirus (HPV) in cervical biopsy tissue or exfoliated cell specimen of Chinese women and to estimate the perspective of HPV prophylactic vaccine in China.

METHODSA total of 18 studies using polymerase chain reaction to detect HPV types were included in this Meta-analysis. There were 1335, 394, 381 and 2584 cases included in invasive cervical cancer (ICC), high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL) and normal group respectively. The overall HPV prevalence was estimated by adjusting the variables using unconditional multiple logistic regression model. HPV type-specific HPV prevalence rates of 18 types including HPV6, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 70, 73 and 82 were estimated, after stratified by cervical lesion of Chinese women.

RESULTSIn ICC, HSIL, LSIL and normal group, the overall HPV prevalence rates were 82.7%, 88.5%, 69.3% and 13.1% respectively, and the HPV16 type-specific prevalence were 61.9%, 46.7%, 21.0% and 3.1%. HIPV16 was the predominant type in all cervical lesion specimen followed by HPV18 and 58 in ICC group, then HPV58 and 52 in HSIL, LSIL and normal. The estimated HPV16/18-positive fractions were 69.6%, 59.1%, 32.3% and 4.4% respectively in ICC, HSIL and normal. Data from the Meta-analysis showed that the top five common HPV types in ICC women were HPV16, 18, 58, 52 and 31 which contributed for 82.9% of the ICC. Thus the HPV16, 18, 31, 33, 35, 45, 52 and 58 were accounted for 87.7% ICC in China mainland.

CONCLUSIONThe proportional impact of HPV16/18 vaccine on ICC was estimated as high as 69.6% in China. HPV58 seemed the priority HPV type and should be emphasized enough to be included in the development of new generation HPV vaccine. However, more uniform standardized multi center studies were necessary to get more exact figure about HPV distribution in China.

Cervical Intraepithelial Neoplasia ; epidemiology ; prevention & control ; virology ; Cervix Uteri ; virology ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Papillomaviridae ; classification ; isolation & purification ; Papillomavirus Infections ; epidemiology ; Papillomavirus Vaccines ; administration & dosage ; Prevalence ; Uterine Cervical Neoplasms ; epidemiology ; virology

OBJECTIVE: To evaluate of liquid based cytology test (LCT) in avoiding medical tangles. METHODS: One thousand five hundred five thirty one cases, which were collected from out-patients of precancerous lesions of uterine cervix, were randomly divided into three groups based on different smear preparation: LCT method was used in two groups (one with ThinPrep kit and one with ArtoBrain kit), conventional Papauicolaou smear (PS) was used in one group. All cases of abnormal cervical smears were identified by cytologic test underwent colposcopic examination and colopscopically multiple biopsy. Results of test were analyzed by software SPSS 11.0. RESULTS: Significant diference were found between LCT method and PS method compared by index of satifacation, sensitivity, specificity, accuracy, false negative rate and erroneous diagnosis rate (P < 0.05, but no difference were found between two LCT groups (ThinPrep kit and ArtoBrain kit). CONCLUSION LCT method can improve diagnostic level of precancerous lesions of uterine cervix either tested by ThinPrep kit or ArtoBrain kit, so have the powerfull value to avoid medical tangles.
Adult ; Aged ; Biopsy/methods* ; Carcinoma, Squamous Cell/pathology* ; Cervix Uteri/pathology* ; Female ; Humans ; Mass Screening/methods* ; Medical Errors/prevention & control* ; Middle Aged ; Sensitivity and Specificity ; Uterine Cervical Neoplasms/pathology* ; Vaginal Smears/methods* ; Young Adult ; Uterine Cervical Dysplasia/pathology*

PURPOSE: This study is conducted to identify the annual average cancer incidence and the trend of cancer incidence in Daegu during the 5-year period from 1997 to 2001. METHOD: Data on newly diagnosed cancer patients from 1997 to 2001 were collected with a standard registration form. Medical record reviewers visited hospitals if necessary, to detect missing cancer patients. RESULTS: The annual average overall number of cancer patient was 4,606 (male 2,529 and female 2,077). The crude average annual incidence of cancer in male were 211.8 (ASR 251.4) and 169.8 (ASR 151.3) in female. Five major cancers in male were stomach (ASR 60.3), bronchus and lung (ASR 44.8), liver and intrahepatic bile ducts (ASR 40.7), rectum (ASR 11.2), and colon (ASR 10.8). However, in women, those were stomach (ASR 25.3), breast (ASR 19.8), cervix (ASR 14.9), bronchus and lung (ASR 12.7), liver and intrahepatic bile ducts (ASR 11.1). Increases in incidence were found for colon cancer for both sexes, rectal cancer for males, and lung and breast cancer for females. Decreases were shown for liver cancer for both sexes and stomach and cervical cancer for females. CONCLUSIONS: Primary prevention of cancer based on results of this study remains important.
Bile Ducts, Intrahepatic ; Breast ; Breast Neoplasms ; Bronchi ; Cervix Uteri ; Colon ; Colonic Neoplasms ; Daegu* ; Female ; Humans ; Incidence* ; Liver ; Liver Neoplasms ; Lung ; Male ; Medical Records ; Primary Prevention ; Rectal Neoplasms ; Rectum ; Registries ; Stomach ; Uterine Cervical Neoplasms

PURPOSE: To analyze the gene expression profiles of uterine cervical cancer, and its variation after radiation therapy, with or without concurrent chemotherapy, using a cDNA microarray. MATERIALS AND METHODS: Sixteen patients, 8 with squamous cell carcinomas of the uterine cervix, who were treated with radiation alone, and the other 8 treated with concurrent chemo-radiation, were included in the study. Before the starting of the treatment, tumor biopsies were carried out, and the second time biopsies were performed after a radiation dose of 16.2~27 Gy. Three normal cervix tissues were used as a control group. The microarray experiments were performed with 5 groups of the total RNAs extracted individually and then admixed as control, pre-radiation therapy alone, during-radiation therapy alone, pre-chemoradiation therapy, and during-chemoradiation therapy. The 33P-labeled cDNAs were synthesized from the total RNAs of each group, by reverse transcription, and then they were hybridized to the cDNA microarray membrane. The gene expression of each microarrays was captured by the intensity of each spot produced by the radioactive isotopes. The pixels per spot were counted with an Arrayguage(R), and were exported to Microsoft Excel(R). The data were normalized by the Z transformation, and the comparisons were performed on the Z-ratio values calculated. RESULTS: The expressions of 15 genes, including integrin linked kinase (ILK), CDC28 protein kinase 2, Spry 2, and ERK 3, were increased with the Z-ratio values of over 2.0 for the cervix cancer tissues compared to those for the normal controls. Those genes were involved in cell growth and proliferation, cell cycle control, or signal transduction. The expressions of the other 6 genes, including G protein coupled receptor kinase 6, were decreased with the Z-ratio values of below -2.0. After the radiation therapy, most of the genes, with a previously increase expressions, represented the decreased expression profiles, and the genes, with the Z-ratio values of over 2.0, were cyclic nucleotide gated channel and 3 Expressed sequence tags (EST). In the concurrent chemo-radiation group, the genes involved in cell growth and proliferation, cell cycle control, and signal transduction were shown to have increased expressions compared to the radiation therapy alone group. The expressions of genes involved in angiogenesis (angiopoietin-2), immune reactions (formyl peptide receptor-like 1), and DNA repair (cAMP phosphodiesterase) were increased, however, the expression of gene involved in apoptosis (death associated protein kinase) was decreased. CONCLUSION: The different kinds of genes involved in the development and progression of cervical cancer were identified with the cDNA microarray, and the proposed theory is that the proliferation signal starts with ILK, and is amplified with Spry 2 and MAPK signaling, and the cellular mitoses are increased with the increased expression of Cdc 2 and cell division kinases. After the radiation therapy, the expression profiles demonstrated the evidence of the decreased cancer cell proliferation. There was no significant difference in the morphological findings of cell death between the radiation therapy alone and the chemo-radiation groups in the second time biopsy specimen, however, the gene expression profiles were markedly different, and the mechanism at the molecular level needs further study.
Apoptosis ; Biopsy ; Carcinoma, Squamous Cell ; Cell Death ; Cell Division ; Cell Proliferation ; Centers for Disease Control and Prevention (U.S.) ; Cervix Uteri ; Cyclic Nucleotide-Gated Cation Channels ; DNA Repair ; DNA, Complementary ; Drug Therapy ; Expressed Sequence Tags ; Female ; Gene Expression* ; GTP-Binding Proteins ; Humans ; Membranes ; Mitosis ; Oligonucleotide Array Sequence Analysis ; Phosphotransferases ; Protein Kinases ; Radioisotopes ; Reverse Transcription ; RNA ; Signal Transduction ; Transcriptome* ; Uterine Cervical Neoplasms*

The anticarcinogenic effects and mechanisms of the biotechnological drugs of Panax ginseng C.A. Meyer cultivated in Russia, bioginseng, panaxel and panaxel- 5, were studied. Bioginseng was produced from a tissue culture of ginseng root cultured on standard medium, whereas panaxel and panaxel-5 were produced from ginseng tissue root cultures using standard mediums enriched with 2-carboxyethylgermanium sesquioxide and 1-hydroxygermatran-monohydrate respectively. All three ginseng drugs inhibited the development of mammary tumors induced by intramammary injections of N-methyl-N-nitrosourea (MNU) in rats, the development of the brain and spinal cord tumors induced by transplacental administration of N-ethyl-N-nitrosourea (ENU) in rats, and the development of uterine, cervical and vaginal tumors induced by intravaginal applications of 7,12-dimethylbenz(a)anthracene (DMBA) in mice. The ginseng drugs induced the cytotoxic activity of macrophages in mice, enhanced T-lymphocyte rosette formation in guinea pigs exposed to cyclophosphamide, and stimulated the production of thyroid hormones in rats. These mechanisms may contribute to the anticarcinogenic action of the ginseng drugs. The organic germanium compounds present in panaxel and panaxel-5 did not potentiate the anticarcinogenic or immuno- stimulatory effects as much as biogeinseng. Preliminary clinical trials with panaxel and bioginseng were carried out in patients with precancerous lesions of the esophagus and endometrium. Panaxel was found to have a strong therapeutic effect in patients suffering from chronic erosive esophagitis. Bioginseng induced the regression of adenomatous-cystic hyperplasia of the endometrium in some patients. Thus, we conclude that the drugs of ginseng appear to hold considerable promise for future cancer chemoprevention.
Adenocarcinoma/chemically induced/prevention & control ; Adult ; Animal ; Antineoplastic Agents, Phytogenic/*therapeutic use ; Cells, Cultured ; Cervix Neoplasms/chemically induced/prevention & control ; Clinical Trials ; Cytotoxicity Tests, Immunologic ; Disease Models, Animal ; Endometrial Neoplasms/pathology/prevention & control ; Endometrium/pathology ; Esophageal Neoplasms/pathology/prevention & control ; Esophagus/pathology ; Estradiol/blood ; Female ; Fibroadenoma/chemically induced/prevention & control ; Human ; Macrophages, Peritoneal/cytology/immunology ; Male ; Mammary Neoplasms, Experimental/chemically induced/prevention & control ; Mice ; Mice, Inbred C57BL ; Neoplasms, Experimental/chemically induced/*prevention & control ; Nervous System Neoplasms/chemically induced/prevention & control ; Panax/*metabolism ; Precancerous Conditions/pathology/*prevention & control ; Rats ; Tissue Culture ; Uterine Neoplasms/chemically induced/prevention & control ; Vaginal Neoplasms/chemically induced/prevention & control

OBJECTIVE: Although a great deal of knowledge accumulated with regard to the causes and epidemiologic features of cervical cancer, primary prevention has not been particularly effective to date. Most efforts with regards of control of cervical cancer have been directed toward secondary prevention with cytologic smears in a screening program. The purpose of this study was to know the cervical smear histories in the women with neoplasia of uterine cervix at present. MATERIALS AND METHOD: Between June, 1993 and October, 1996, seventy women with invasive cervical carcinoma and eighty-seven women with cervical intraepithelial neoplasia(CIN) were interviewed about cervical smear histories to assess the frequencies of past smear at the Soonchunhyang University Hospital. RESULTS: The results were follows: 1. The mean age of the women with invasive cervical cancer and CIN were 55+/-9 and 42+/-11, respectively. 2. Of the 70 cases of cervical cancer, 61%(43/70) has not been screened, compared with 43%(37/87) in cases of CIN. 3. The mean ages at first smear in the cases of previous smear were 42+/-6 of 27 cancers, 37+/-7 of 50 CINs. The gap between the age at the first smear and the age at diagnosis were about 6 years in cases of cervical cancers, about 5 years in cases of CIN. 4. The most common symptom in cervical cancers was vaginal bleeding or postcoital bleeding(57%). Although 13%(9/70) were discovered during screening without symptom in the women with cervical cancers, 58%(52/87) were diagnosed incidently during screening in CIN. 5. Pap smear numbers before diagnosis were strongly associated with age and stage. Among women diagnosed with invasive cancer under the age of 49, 75% had at least one cervical smear. But, all women with cervical cancer over age of 65 have not been screened. Unscreened rates of stage I, II, III, and IV were 34%, 78%, 85% and 83% respectively. 6. Among 38 cases who had undergone radiation therapy, 82%(31/38) had not been screen in contrast to 38%(12/32) in the women who had undergone radical surgery. 7. Among women with previous smears in the cervical cancer, 20%(14/70) have been screened within 1year. CONCLUSION: It is likely to diagnosis cervical cancer who had normal papanicolau smear in recent. So papanicolau smear is examined carefully and other adjunctive test is help to diagnosis cervical cancer exactly, for example cervicography, HPV testing.
Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Diagnosis* ; Female ; Humans ; Mass Screening ; Primary Prevention ; Secondary Prevention ; Uterine Cervical Neoplasms* ; Uterine Hemorrhage ; Vaginal Smears

The accuracy of Kato's self smear Kit was studied in screening a relatively unselected population group for cervical cancer. Routine cervicovaginal smears taken periodically would be the ideal method but would be unrealistic in view of the physician's time involved when considered on a large population scale. Three hundred patients were randomly selected at the Out Patient Clinic of Yonsei Medical Center and 26 cases grossly of cervical cancer were included in this group. We have here summarized the results briefly as follows. 1. Among 300 women examined in our OPD, 256 (85.3%) were classified as Pap. Class I or II, 9(0.3%) as a 'Defferred' group (Class II, Repeat), 18(6%) as Class III and 17(5.7%) as Class IV or V. 2. Fifteen of the total cases had insufficient material for evaluation (poor quality) and the major causes of the poor smears were vaginal douche within 24 hours, technical problems and cell degeneration. 3. The rate of agreement between the Self Smear Kit and cervicovaginal smear was as follows: a. The rate of complete agreement was 93.2% (280/300) b. The rate of complete or partial agreement was 96.7% (290/300). 4. The diagnostic accuracy of the Self Smear Kit was as follows: a. If we assumed the 'Deferred' group to be detection failures for uterine cancer, the diagnostic accuracy would be 82.4%. b. If we assumed the 'Deferred' group to be detection successes, the diagnostic accuracy would be 94.1%. 5. The quality of self smears was superior when taken by an aid nurse rather than by the patient herself. 6. Optimal time for good preservation with the Self Smear Kit prior to pap. stain under the following temperatures was proven experimentally to be as follows; a. At 5 degrees C: 3 days after smear b. At 15 degrees C: 3 days after smear c. At 30 degrees C: 2 days after smear
Adult ; Cervix Neoplasms/prevention & control* ; Female ; Human ; Mass Screening/methods* ; Middle Age ; Vaginal Smears/instrumentation ; Vaginal Smears/methods*