Gynecologic Oncology Reports最新文献_第8页

Early introduction of trastuzumab deruxtecan (T-DXd) in HER2 expressing rare gynecologic malignancies – How early is too early? 早期引入曲妥珠单抗德鲁西替康（T-DXd）治疗表达HER2的罕见妇科恶性肿瘤-多早是太早？

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-10-01 DOI: 10.1016/j.gore.2025.101965

Jennifer McEachron, Jamie N. Bakkum-Gamez

引用次数: 0

Themes, perspectives, and educational quality of content related to #PapSmears on TikTok TikTok上与#PapSmears相关的主题、观点和教育质量

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-10-01 DOI: 10.1016/j.gore.2025.101964

Stephany Amezcua , Matthew W. Lee , Laurel S. Aberle , Katelyn B. Furey , Xiaoyue Mona Guo

Objective

To evaluate TikTok videos with the hashtag #PapSmear and analyze their educational quality, themes, tone, creator, and engagement metrics.

Methods

A cross-sectional analysis of the top 150 TikTok videos with #PapSmear was conducted in September 2023. Videos were evaluated by four independent reviewers for engagement metrics, video topic, intent, tone, creator, and themes. The educational quality of videos was assessed using the brief DISCERN tool. Statistical analyses were performed to examine differences and relationships across groups.

Results

Among the 150 videos reviewed, 75.3 % focused on Pap smears, while 24.7 % discussed pelvic exams. Patients created 60.7 % of videos while healthcare providers contributed 39.3 %. Videos created by healthcare providers were more likely to be neutral or positive in tone and focus on educational content. Videos created by patients tended to have a negative tone, often focusing on personal experiences or comedy. Negative tones were significantly associated with higher engagement by “likes” and “shares” compared to neutral and positive tones. DISCERN scores were low across all videos. Healthcare provider videos did not score significantly higher than patient-generated content (p > 0.05). 10 % (n = 15) of videos addressed trauma related to a Pap smear or pelvic exam.

Conclusion

Our analysis of the top 150 TikTok videos with #papsmear shows low educational quality across all creators, highlighting the difficulty of providing accurate health information on social media. To improve the quality and impact of health communication on social media, healthcare professionals might consider integrating relatable storytelling and appropriate humor while still prioritizing medical accuracy and trauma-informed messaging.

目的评估带有#PapSmear标签的TikTok视频，并分析其教育质量、主题、语气、创作者和参与度指标。方法对2023年9月排名前150位的带有#PapSmear的TikTok视频进行横断面分析。视频由四名独立评审员对参与指标、视频主题、意图、语气、创作者和主题进行评估。使用简短的DISCERN工具评估视频的教育质量。进行统计分析以检验各组之间的差异和关系。结果在150个视频中，75.3%的视频集中于巴氏涂片检查，24.7%的视频集中于盆腔检查。患者创造了60.7%的视频，而医疗服务提供者贡献了39.3%。由医疗保健提供者制作的视频更有可能是中立或积极的语气，并专注于教育内容。患者制作的视频往往带有消极的基调，通常侧重于个人经历或喜剧。与中性和积极的语气相比，消极语气与“喜欢”和“分享”的参与度显著相关。在所有视频中，DISCERN得分都很低。医疗保健提供者视频的得分并不显著高于患者生成的内容（p > 0.05）。10% （n = 15）的视频涉及与子宫颈抹片检查或盆腔检查有关的创伤。我们对排名前150位的带有#papsmear的TikTok视频的分析显示，所有创作者的教育质量都很低，这凸显了在社交媒体上提供准确健康信息的难度。为了提高社交媒体上健康传播的质量和影响，医疗保健专业人员可能会考虑整合相关的故事和适当的幽默，同时仍然优先考虑医疗准确性和创伤信息。

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引用次数: 0

Insights from plastic and reconstructive surgery wound specialists in managing complex vaginal and vulvar toxicities following radiation therapy 来自整形和重建外科伤口专家在放射治疗后处理复杂阴道和外阴毒性的见解

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-10-01 DOI: 10.1016/j.gore.2025.101966

Ovya Ganesan , Stephanie M. Mueller , Diana Miao , M Aiven Dyer , Natalie Cain , Colleen M. Feltmate , Dennis P. Orgill

Objective

Radiation therapy is essential for treating vaginal and vulvar cancers but can cause chronic pain, sexual dysfunction, infections, and delayed wound healing. These complications profoundly impact survivors’ quality of life and may impede cancer-directed treatment in recurrent disease. We describe a multidisciplinary approach involving Plastic and Reconstructive Surgery, Gynecologic Oncology, and Radiation Oncology for managing complex radiation-induced wounds.

Methods

We retrospectively reviewed two patients with severe vaginal/vulvar radiation wounds treated at a tertiary wound care center.

Results

Case 1: A 71-year-old woman with vulvar squamous cell carcinoma (VSCC) underwent vulvectomy and adjuvant chemoradiation, developing acute radiation dermatitis. Recurrent VSCC required further surgery, and reconstruction was complicated by wound necrosis, which was treated with debridement, quarter-strength sodium hypochlorite and advanced dressings. Following a third vulvectomy for further recurrence, she again demonstrated impaired wound healing. Despite ongoing management, cancer persists.

Case 2: A 73-year-old woman with locally advanced endometrial adenocarcinoma received chemotherapy, external radiation, brachytherapy, hysterectomy with bilateral salpingo-oophorectomy, and stereotactic radiation for bone metastasis. Two years post-radiation, she developed vaginal necrosis, which was managed with hypochlorous acid solution, sharp debridement, and hyperbaric oxygen therapy. She recently enrolled in a clinical trial for persistent cancer.

In both cases, wound complications delayed optimal cancer-directed therapy.

Conclusion

These cases highlight the importance of a multidisciplinary strategy to manage severe radiation-induced vaginal/vulvar wounds. Focused on pain control, odor reduction, and optimizing the wound environment, care is often palliative given disease complexity, underscoring the challenges in balancing wound healing with ongoing cancer treatment.

目的放射治疗是治疗阴道和外阴癌的必要手段，但放射治疗可引起慢性疼痛、性功能障碍、感染和伤口愈合延迟。这些并发症深刻地影响了幸存者的生活质量，并可能阻碍复发性疾病的癌症定向治疗。我们描述了一种涉及整形和重建外科，妇科肿瘤学和放射肿瘤学的多学科方法来处理复杂的辐射引起的伤口。方法回顾性分析在三级伤口护理中心治疗的2例严重阴道/外阴放射伤患者。结果病例1:1例71岁女性外阴鳞状细胞癌（VSCC）行外阴切除术和辅助放化疗，并发急性放射性皮炎。复发的VSCC需要进一步手术，重建时伤口坏死，用清创、四分之一强度的次氯酸钠和高级敷料治疗。第三次外阴切除术后再次复发，伤口愈合受损。尽管进行了持续的治疗，癌症仍然存在。病例2:73岁女性局部晚期子宫内膜腺癌患者，行化疗、外置放疗、近距离放疗、双侧输卵管卵巢切除术、立体定向放疗治疗骨转移。放疗后两年，患者出现阴道坏死，经次氯酸溶液、急剧清创和高压氧治疗。她最近参加了一项针对持续性癌症的临床试验。在这两种情况下，伤口并发症延迟了最佳的癌症定向治疗。结论这些病例强调了多学科治疗严重放射性阴道/外阴损伤的重要性。考虑到疾病的复杂性，以疼痛控制、减少气味和优化伤口环境为重点的护理往往是姑息性的，这强调了平衡伤口愈合与正在进行的癌症治疗的挑战。

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引用次数: 0

Radical resection and sentinel lymph node evaluation of mammary-like adenocarcinoma of the vulva (MLAV) with somatic BRCA1 mutation 伴有BRCA1体细胞突变的外阴乳腺样腺癌（MLAV）根治性切除和前哨淋巴结的评估

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-10-01 DOI: 10.1016/j.gore.2025.101957

Lilla Markel , Lidys Rivera , A. Ordobazari , Ardeshir Hakam , Wilfredo Lorenzo , Mitchel S. Hoffman , Robert M. Wenham , Monica Avila

Background

Mammary-like gland adenocarcinoma of the vulva is a rare and aggressive form of vulvar cancer with histopathologic resemblance to breast cancer. This rare type of vulvar cancer develops from primary metaplasia of mammary-like anogenital glands, more recently discovered anatomic components of the anogenital region.

Case presentation

We present a 77-year-old African-American female with a six-month history of painless, left lower vulvar lesion referred to our cancer center following confirmatory biopsy of invasive mammary type adenocarcinoma. Preoperative PET CT demonstrating focal avidity (SUV 7.8) in the vulvar region with no evidence of metastatic disease. She underwent exam under anesthesia, left radical vulvar excision with primary closure, left inguinal sentinel lymph node mapping and biopsy for a TNM stage of T2N0M0 and vulvar FIGO stage IB grade 2. Somatic testing was significant for a BRCA1 mutation (variant p.S770, c.2309C>G).

Conclusion

Mammary-like gland adenocarcinoma of the vulva is a rare but aggressive neoplasm that presents diagnostic challenges due to its resemblance to breast carcinoma. Radical resection and sentinel lymph node assessment is feasible. Melanocytic skin types pose a unique set of differences regarding detection, diagnosis and potential genomic variations such as BRCA1 mutation in our patient. Genetic and genomic assessments should be considered to further guide optimal therapeutic options.

背景外阴乳腺样腺癌是一种罕见的侵袭性外阴癌，其组织病理学与乳腺癌相似。这种罕见的外阴癌是由乳腺样的肛门生殖器腺的原发性化生引起的，这是最近在肛门生殖器区域发现的解剖成分。我们报告一位77岁的非裔美国女性，有6个月的无痛病史，左侧下外阴病变，在浸润性乳腺型腺癌的确诊活检后转到我们的癌症中心。术前PET CT显示外阴区域局灶性贪婪（SUV 7.8），无转移性疾病的证据。她在麻醉下接受了检查，左侧外阴根治性切除并初步闭合，左侧腹股沟前哨淋巴结定位和活检，TNM分期为T2N0M0，外阴FIGO分期为IB级2级。体细胞检测显示BRCA1突变显著（p.S770, c.2309C>；G）。结论外阴乳腺样腺癌是一种罕见但侵袭性的肿瘤，因其与乳腺癌相似而给诊断带来挑战。根治性切除和前哨淋巴结评估是可行的。黑色素细胞皮肤类型在检测、诊断和潜在的基因组变异（如患者的BRCA1突变）方面存在独特的差异。应考虑遗传和基因组评估，以进一步指导最佳治疗方案。

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引用次数: 0

Durable complete response with chemo-immuno-radiotherapy for metastatic cervical cancer progressing under immunotherapy: a case series 化疗-免疫-放射治疗在免疫治疗下进展的转移性宫颈癌的持久完全缓解：一个病例系列

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-10-01 DOI: 10.1016/j.gore.2025.101967

Thomas Westerhoff , Nathalie Baudoux , Manuela Undurraga , Patrick Petignat , Intidhar Labidi-Galy , Melpomeni Kountouri

Objectives

The prognosis for metastatic cervical cancer has dramatically improved in the past years with the addition of anti-PD1/PD-L1 immunotherapy to standard platinum-based chemotherapy +/-bevacizumab. Here, we aimed to investigate the benefit from combining chemo-immuno-radiotherapy for metastatic cervical cancer patients who had oligo-metastasis progression under maintenance immunotherapy, while the other metastatic sites are in remission.

Methods

We report a case series of two patients diagnosed with multisite metastatic cervical cancer (including peritoneal carcinomatosis) who, after an initial response to pembrolizumab, presented with pelvic progression while maintaining complete regression of extra-pelvic metastases. Both patients underwent radical pelvic external beam radiotherapy (EBRT) and concomitant chemotherapy with weekly cisplatin +/- brachytherapy, while pursuing immunotherapy with pembrolizumab.

Results

The two patients achieved durable complete response after completing this treatment scheme and tolerated it well. Patient 1 is in complete response 30 months after the end of chemo-radiotherapy. Patient 2 is in complete response 24 months after the end of chemo-radiotherapy.

Conclusions

This case series suggests that chemo-immuno-radiotherapy with EBRT may represent a salvage treatment for patients who develop secondary loco-regional resistance to immunotherapy, as long as there is remission of the metastatic sites. Given the low response rate to chemotherapy in metastatic cervical cancer patients resistant to pembrolizumab, chemo-radiotherapy while pursuing immunotherapy should be investigated in highly selected patients with oligo-metastasis progression.

目的：近年来，随着抗pd - 1/PD-L1免疫治疗在标准铂基化疗+/-贝伐单抗基础上的应用，转移性宫颈癌的预后得到了显著改善。在这里，我们的目的是研究化疗-免疫-放疗联合治疗在维持免疫治疗下有低转移进展的转移性宫颈癌患者的益处，而其他转移部位处于缓解期。方法：我们报告了两例诊断为多部位转移性宫颈癌（包括腹膜癌）的患者，在对派姆单抗有初步反应后，出现盆腔进展，同时保持盆腔外转移完全消退。两名患者均接受根治性盆腔外束放疗（EBRT）和伴随化疗，每周顺铂+/-近距离放疗，同时使用派姆单抗进行免疫治疗。结果两例患者在完成该治疗方案后均获得持久完全缓解，耐受性良好。患者1在放化疗结束后30个月完全缓解。患者2在放化疗结束后24个月完全缓解。结论：该系列病例表明，只要转移部位缓解，化疗-免疫放疗结合EBRT可能是对免疫治疗产生继发性局部耐药的患者的救助性治疗。鉴于对派姆单抗耐药的转移性宫颈癌患者化疗应答率低，应在高度选择性的低转移进展患者中研究化疗放疗同时进行免疫治疗。

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引用次数: 0

Combined imaging and surgical predictors of cardiophrenic lymph node metastasis in ovarian cancer patients undergoing upfront surgery 术前卵巢癌患者心性淋巴结转移的综合影像学和手术预测因素

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-10-01 DOI: 10.1016/j.gore.2025.101962

Uisuk Kim , Ji Hyun Kim , Jae Won Song , Jin-Ho Choi , Sun Ho Kim , Sang-Yoon Park , Myong Cheol Lim

Objectives

The aim of this study was to identify preoperative and intraoperative factors associated with cardiophrenic lymph node (CPLN) metastasis and to evaluate their potential role in surgical decision-making in patients undergoing upfront surgery for ovarian cancer. Because unsuspected CPLN involvement can compromise the ability to achieve no gross residual disease, early identification may guide surgical planning and selection of candidates for CPLN dissection.

Methods

From 2010 to 2023, electronic medical records of patients with upfront cytoreductive surgery including cardiophrenic lymph node (CPLN) dissection were reviewed and retrospectively analyzed.

Results

A total of 165 patients underwent upfront cytoreductive surgery, including CPLN dissection, and 100 patients (60.6 %) were confirmed CPLN metastasis. Patients with CPLN metastasis showed a larger short-axis diameter on CT than those without CPLN metastasis (7.95 mm and 6.8 mm, p < 0.0001, respectively) and the best predictive cutoff value for short-axis length was 7.7 mm. (sensitivity 0.600 and specificity 0.754) In multivariate analysis, seeding on the diaphragm was associated with CPLN metastasis (p < 0.0001), and intra-abdominal residual disease was associated with CPLN metastasis (p = 0.0029).

Conclusion

This study suggested preoperative and intraoperative factors associated with CPLN metastasis in ovarian cancer, including short-axis diameter, diaphragmatic involvement, and residual disease. While each factor has limitations as a standalone predictor, their combined assessment may provide useful guidance for surgical evaluation and planning in selected patients.

目的本研究的目的是确定术前和术中与心心淋巴结（CPLN）转移相关的因素，并评估它们在卵巢癌术前手术决策中的潜在作用。由于未预料到的CPLN受累可能会损害无总体残留病变的能力，因此早期识别可以指导手术计划和选择CPLN解剖的候选人。方法回顾性分析2010 ~ 2023年我院行包括心电淋巴结清扫在内的术前细胞减缩手术患者的电子病历。结果165例患者接受了包括CPLN剥离在内的前期细胞减缩手术，其中100例（60.6%）确诊为CPLN转移。有CPLN转移的患者在CT上的短轴直径比无CPLN转移的患者大（分别为7.95 mm和6.8 mm, p < 0.0001），短轴长度的最佳预测临界值为7.7 mm。（敏感性0.600，特异性0.754）在多因素分析中，膈膜上播种与CPLN转移相关（p < 0.0001），腹腔内残留病变与CPLN转移相关（p = 0.0029）。结论本研究提示术前和术中与卵巢癌CPLN转移相关的因素包括短轴直径、膈受累和残留病变。虽然每个因素作为单独的预测因素都有局限性，但它们的综合评估可能为选定患者的手术评估和计划提供有用的指导。

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引用次数: 0

Corrigendum to “Case report of a squamous cell carcinoma arising in a vulvar cutaneous horn” [Gynecol. Oncol. Rep. 60C (2025) 101784] 《外阴皮角发生鳞状细胞癌的病例报告》的更正[妇科杂志]。肿瘤防治杂志。众议员60C (2025) 101784]

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-10-01 DOI: 10.1016/j.gore.2025.101946

Michael Bell , Robert Tucker Burks , Erin Crane

引用次数: 0

Tamoxifen for nodal recurrence of serous borderline ovarian tumour − a case report 他莫昔芬治疗浆液性交界性卵巢肿瘤结性复发1例

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-10-01 DOI: 10.1016/j.gore.2025.101960

Alyssia Guarneri , Xing Zeng , Reitan Ribeiro , Shuk On Annie Leung , Victoria Mandilaras , Basile Tessier-Cloutier , Lili Fu , Tuyet Nhung Ton Nu , Lara Richer , Lucy Gilbert , Laurence Bernard

Background

Serous borderline ovarian tumours (SBTs) are rare epithelial neoplasms typically associated with excellent long-term survival. Most recurrences occur within the first decade and are limited to the peritoneum. Nodal recurrence after several decades is exceedingly rare. Hormonal therapy is well-established in low-grade serous carcinoma (LGSC), but its role in borderline tumours remains undefined.

Case presentation

We describe the case of a 68-year-old woman with a history of advanced stage serous borderline ovarian tumour, previously treated surgically in the 1980s. After 37 years of disease-free survival, she presented with abdominopelvic pain and was found to have biopsy-confirmed recurrence in multiple nodal regions, including bilateral external iliac and mesenteric lymph nodes. Surgical debulking was performed, confirming SBT. The surgery was complicated by a left external iliac vein injury. Postoperatively, the course was complicated by extensive bilateral deep vein thromboses requiring long-term anticoagulation, as well as a left inguinal lymphocele. She subsequently developed progression in the right external iliac nodes eight months later. Due to surgical complexity, further resection was not pursued, and the patient was initiated on hormonal therapy with Tamoxifen. Follow-up imaging demonstrated partial response.

Conclusion

This case highlights the rare phenomenon of late nodal recurrence in borderline ovarian tumours and illustrates the potential role of hormonal therapy in selected cases where surgery is no longer feasible.

浆液性交界性卵巢肿瘤（sbt）是一种罕见的上皮性肿瘤，通常具有良好的长期生存率。大多数复发发生在头十年，并局限于腹膜。几十年后淋巴结复发极为罕见。激素治疗是建立在低级别浆液性癌（LGSC），但其在交界性肿瘤的作用仍不清楚。病例介绍：我们报告一位68岁的女性，她患有晚期浆液性交界性卵巢肿瘤，曾在20世纪80年代接受过手术治疗。37年无病生存后，她出现了腹盂疼痛，并被活检证实在多个淋巴结区域复发，包括双侧髂外淋巴结和肠系膜淋巴结。手术切除，确认SBT。手术因左髂外静脉损伤而复杂化。术后，该过程因广泛的双侧深静脉血栓形成而复杂化，需要长期抗凝治疗，以及左侧腹股沟淋巴囊肿。8个月后，患者右髂外淋巴结出现进展。由于手术复杂性，未进行进一步切除，患者开始接受他莫昔芬激素治疗。随访影像显示部分反应。结论本病例强调了交界性卵巢肿瘤晚期淋巴结复发的罕见现象，并说明了激素治疗在选择手术不再可行的病例中的潜在作用。

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引用次数: 0

Gastropleural fistula following advanced stage ovarian cancer interval cytoreductive surgery: A case report and review of the literature 晚期卵巢癌间隔期细胞减少手术后胃胸膜瘘：1例报告及文献复习

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-10-01 DOI: 10.1016/j.gore.2025.101956

Sofia Bigardi, Giulia Spagnol, Livia Xhindoli, Matteo Marchetti, Orazio De Tommasi, Marco Noventa, Carlo Saccardi, Roberto Tozzi

Introduction

Gastropleural fistula (GPF) is an exceptionally rare complication in oncologic surgery, most often reported after thoracic or abdominal procedures and only sporadically described in ovarian cancer.

Case report

We describe a 72-year-old woman with advanced high-grade serous ovarian cancer who underwent interval cytoreductive surgery including bilateral diaphragmatic peritonectomy. Despite achieving optimal cytoreduction (RT 0), her postoperative course was complicated by the onset of dyspnea and hydropneumothorax. A contrast-enhanced CT scan demonstrated a fistulous tract between the gastric fundus and the pleural cavity. She underwent partial gastrectomy, diaphragmatic repair, and thoracic washout, with resolution of the fistula. No adjuvant chemotherapy was given, and disease recurrence occurred after five months, treated with carboplatin plus gemcitabine.

Conclusions

This case illustrates that GPF, although extremely uncommon in gynecologic oncology, can occur after extensive diaphragmatic surgery in multimorbid and heavily pre-treated patients. A narrative review of the literature highlights common mechanisms—including tissue ischemia, impaired healing, and oncologic treatments—across both gynecologic and non-gynecologic cases. Early recognition and prompt surgical management are essential for favorable outcomes.

星形胸膜瘘（GPF）是肿瘤外科手术中一种非常罕见的并发症，最常在胸部或腹部手术后报道，仅在卵巢癌中偶有报道。病例报告我们描述了一位72岁晚期浆液性卵巢癌的女性，她接受了间隔细胞减少术，包括双侧膈腹膜切除术。尽管达到了最佳的细胞减少（RT 0），但她的术后过程因呼吸困难和气胸积液的发作而复杂化。CT增强扫描显示胃底和胸膜腔之间有瘘道。她接受了部分胃切除术、膈修复术和胸腔冲洗术，瘘管得到了解决。未给予辅助化疗，5个月后疾病复发，卡铂加吉西他滨治疗。结论：本病例表明，尽管GPF在妇科肿瘤中极为罕见，但在多病和大量术前治疗的广泛膈手术后也可能发生。对文献的叙述性回顾强调了妇科和非妇科病例的常见机制，包括组织缺血，愈合受损和肿瘤治疗。早期识别和及时的手术治疗是获得良好结果的必要条件。

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引用次数: 0

Cervical HPV 18 detection is associated with high-grade cervical dysplasia in Kenyan and Ugandan women living with HIV 在肯尼亚和乌干达感染艾滋病毒的妇女中，宫颈HPV 18检测与高度宫颈发育不良有关

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-19 DOI: 10.1016/j.gore.2025.101953

Miriam Nakalembe , Collins Mpamani , Jane Namugga , Carolyn Nakisige , Grace Banturaki , Phillip Tonui , Peter Itsura , Omenge Orang’o , Kapten Muthoka , Anthony Ngeresa , Beverly Musick , Aaron Ermel , Patrick Loehrer , Darron R. Brown , Yan Tong

Objectives

Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).

Methods

Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical swabs was performed (Roche Cobas Assay); all WLWH underwent cervical biopsy on two occasions.

Results

Of 114 WLWH enrolled, the median age was 38.2 years. All WLWH were receiving ART during the study. CIN2/3 was found in 13 (11.4 %) WLWH; HPV 16 was detected in 10 (8.8 %); HPV 18 in 11 (9.6 %), and Non-16/18 HR-HPV in 62 (54.4 %). Aflatoxin exposure was not associated with CIN2/3 in this analysis. A multivariable logistic regression found that cervical detection of HPV 18 was significantly associated with CIN2/3 (OR = 6.36, 95 % CI = 1.36–29.75, p = 0.019), after adjusting for the effects of HIV viral load, CD4 counts, and Non-16/18 HR-HPV detection.

Conclusions

CIN2/3 was detected in 11.4% of WLWH; HPV 18 detection in cervical swabs was strongly associated with CIN2/3. Larger studies among WLWH are needed to determine optimal approaches for screening and treatment to prevent cervical cancer.

目的宫颈癌是由“高危”（HR） HPV引起的，是肯尼亚和乌干达妇女最常见的恶性肿瘤，也是癌症死亡的主要原因。感染艾滋病毒（WLWH）的妇女感染HR-HPV的风险很高。这项纵向、观察性队列分析旨在确定WLWH中预测宫颈上皮内瘤变2级或3级（CIN2/3）的重要因素。方法本分析的数据基于对肯尼亚和乌干达WLWH中HPV自然史和宫颈癌的研究。收集了人口统计、行为和生物学数据；对宫颈拭子进行HR-HPV DNA检测（Roche Cobas Assay）；所有WLWH均有两次宫颈活检。结果114例WLWH入组，中位年龄为38.2岁。所有WLWH在研究期间均接受抗逆转录病毒治疗。13例（11.4%）WLWH中发现CIN2/3；10例（8.8%）检出HPV 16型；HPV 18 11例（9.6%），非16/18 HR-HPV 62例（54.4%）。在本分析中，黄曲霉毒素暴露与CIN2/3无关。多变量logistic回归发现，在调整HIV病毒载量、CD4计数和Non-16/18 HR-HPV检测的影响后，宫颈HPV 18检测与CIN2/3显著相关（OR = 6.36, 95% CI = 1.36-29.75, p = 0.019）。结论11.4%的WLWH检出scin2 /3；宫颈拭子中HPV 18的检测与CIN2/3密切相关。需要在WLWH中进行更大规模的研究，以确定筛查和治疗宫颈癌的最佳方法。

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引用次数: 0