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High-risk human papillomavirus screening and testing with immunohistochemical surrogate biomarkers: an alternative to polymerase chain reaction 高危人乳头瘤病毒筛选和检测与免疫组织化学替代生物标志物:替代聚合酶链反应
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441188
L. V. van Bogaert
The vacuolisation and ballooning of cervical squamous cells, presently known as koilocytosis, was first described in 1957 by FW Stewart, who defined it as “warty atypia” (a hint towards a possible viral link). The presence of viral particles in the nuclei of epithelial cells of condylomata was first documented electron microscopically by AEG Dunn and NM Ogilvie in 1968. Similarities between condylomata and cervical precancerous lesions led to the hypothesis that the papovavirus causing condylomata may be a contributory factor in cervical carcinogenesis. This hypothesis was confirmed in 1978 by Laverty et al, with the electron microscopic identification of viral particles consistent with a papillomavirus, in a preinvasive lesion in an immunosuppressed woman.1
1957年,FW Stewart首次描述了宫颈鳞状细胞的空泡化和膨胀,目前称为空洞细胞增多症,他将其定义为“疣样异型”(暗示可能与病毒有关)。1968年,AEG Dunn和NM Ogilvie首次在电子显微镜下记录了尖锐湿疣上皮细胞细胞核中病毒颗粒的存在。尖锐湿疣和宫颈癌前病变之间的相似性导致了一种假设,即引起尖锐湿疣的乳头状病毒可能是宫颈癌发生的一个促成因素。1978年,Laverty等人证实了这一假设,在一名免疫抑制妇女的侵袭前病变中,电子显微镜下发现了与乳头瘤病毒一致的病毒颗粒
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引用次数: 2
35th National Congress of the South African Society of Obstetricians and Gynaecologists 南非妇产科医师协会第35届全国代表大会
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441191
Cervical cancer incidence in Africa in 2008 was equivalent to the incidence in Scandinavian countries prior to the implementation of cytology based screening programmes in the early part of the 20th century. With the introduction of cytology based programmes the incidence of and mortality from cervical cancer fell substantially and today, in well organised screening programmes that function optimally, cervical cancer is a rare disease. SubSaharan Africa has faced many challenges in the past 300 years, not the least being the long term impact of colonialism, systemically racist governments and then post liberation, the legacies of poor governance, lack of financial, human and many other resources. Because cervical cancer is a largely preventable disease, coupled with an awareness that cytology based programmes are hard to initiate, implement or sustain, a concerted effort to find alternative screening tools and approaches has been attempted in the past 15 years. These studies have evaluated a range of alternative screening tests, including visual inspection methods which have involved thousands of women in Africa, Asia and Latin America. These studies have consistently shown the much greater sensitivity of molecular testing with Human papillomavirus (HPV) DNA testing compared to cytology, but with a lower positive predictive value and specificity. However, the near 100% negative predictive value makes it an ideal test for settings where women will be screened, if at all, only once or twice in a lifetime. The most critical factor in setting up secondary prevention for cervical cancer is the creation of an appropriate infrastructure and to provide adequate resources for the programme to function. Primary prevention of cervical cancer through HPV vaccination offers a whole new approach and opportunity to prevent cervical cancer by preventing infection with high risk types of HPV, known to be aetiologically associated with cervical cancer. However, implementing HPV vaccination is a relatively complex process in countries that lack immunisation programmes for adolescent/pubescent children. Vaccination though has proved to be a very successful public health intervention and with the pressure of the Millennium Development Goals, population coverage with other types of vaccines has improved significantly in developing countries, reaching over 90% in many areas. Can cervical cancer be prevented in Africa? Yes it can, but whether resources will be allocated to these programmes will ultimately be decided by those in control of resources (usually politicians). A commitment and realisation from the governments of Africa that investing in the health of their women is cost-effective, reduces poverty, and uplifts the growth of nations at all levels. The MDGs have made women’s health a priority. Cervical cancer fits into this paradigm.
2008年非洲的宫颈癌发病率与斯堪的纳维亚国家在20世纪初实施细胞学筛查方案之前的发病率相当。随着以细胞学为基础的方案的实施,宫颈癌的发病率和死亡率大幅下降,今天,在组织良好、发挥最佳作用的筛查方案中,宫颈癌是一种罕见的疾病。撒哈拉以南非洲在过去的300年里面临着许多挑战,其中最重要的是殖民主义的长期影响,系统的种族主义政府以及解放后的种族主义政府,治理不善的遗留问题,缺乏财政、人力和许多其他资源。由于宫颈癌在很大程度上是一种可预防的疾病,再加上人们认识到基于细胞学的方案难以启动、实施或维持,因此在过去15年中,一直在努力寻找其他筛查工具和方法。这些研究评估了一系列可供选择的筛查试验,包括目视检查方法,涉及非洲、亚洲和拉丁美洲的数千名妇女。这些研究一致表明,与细胞学相比,人乳头瘤病毒(HPV) DNA检测的分子检测灵敏度要高得多,但阳性预测值和特异性较低。然而,接近100%的阴性预测值使它成为一个理想的测试,如果有的话,女性一生中只有一两次进行筛查。建立宫颈癌二级预防的最关键因素是建立适当的基础设施,并为该方案的运作提供足够的资源。透过接种人乳头瘤病毒疫苗,预防与子宫颈癌有关的高危型人乳头瘤病毒感染,为预防子宫颈癌提供了一种全新的方法和机会。然而,在缺乏青少年/青春期儿童免疫规划的国家,实施HPV疫苗接种是一个相对复杂的过程。尽管疫苗接种已被证明是一项非常成功的公共卫生干预措施,而且在千年发展目标的压力下,发展中国家其他类型疫苗的人口覆盖率已大大提高,在许多地区达到90%以上。子宫颈癌在非洲可以预防吗?是的,它可以,但是否将资源分配给这些项目,最终将由控制资源的人(通常是政治家)决定。非洲各国政府承诺并认识到,投资于妇女健康具有成本效益,可以减少贫困,并促进各国在各个层面的增长。千年发展目标将妇女健康列为优先事项。子宫颈癌符合这种模式。
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引用次数: 0
Meeting future requirements in gynaecological oncology subspecialty training 满足妇科肿瘤专科培训的需求
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441193
L. Snyman
Subspecialty training in gynaecological oncology in South Africa is a very young venture in the discipline of gynaecology. In 2008, the first candidate fulfilled the requirements for the College of Obstetricians and Gynaecologists of South Africa’s subspecialty certificate in Gynaecological Oncology. As a subspecialty, gynaecological oncology adds significant value to the management and care of women who are diagnosed with gynaecological cancer, and enhances survival and treatment outcome. 1 Therefore, there is no doubt that it is judicious to train gynaecological oncologists in South Africa.
南非妇科肿瘤专科培训是妇科学科中一个非常年轻的项目。2008年,第一位获得南非妇产科学院妇科肿瘤专科证书的候选人。作为一个亚专科,妇科肿瘤学为诊断患有妇科癌症的妇女的管理和护理增加了重要的价值,并提高了生存率和治疗效果。因此,毫无疑问,在南非培训妇科肿瘤学家是明智的。
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引用次数: 2
Venous thrombosis in the patient with cancer 癌症患者静脉血栓形成
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441194
P. Wessels
Abstract The relationship between cancer and thrombosis has been known for many years. Thrombotic risk is increased in the patient with cancer, and the diagnosis of venous thromboembolism at the time that a malignancy presents influences patient outcome. Risk evaluation, prophylaxis and treatment of venous thromboembolism are practical issues that face doctors who are dealing with these patients.
癌症与血栓形成之间的关系已为人们所知多年。癌症患者的血栓形成风险增加,在出现恶性肿瘤时诊断静脉血栓栓塞会影响患者的预后。静脉血栓栓塞的风险评估、预防和治疗是治疗这些患者的医生面临的实际问题。
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引用次数: 0
Knowledge, awareness and utilisation of the human papillomavirus vaccine in Durban 德班人乳头瘤病毒疫苗的知识、认识和利用情况
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441185
N. Allie, M. Moodley
Abstract Background: Human papillomavirus (HPV) is the causative agent of cervical cancers, low-grade cervical lesions, and warts of the genital tract. Since March 2008, a vaccine against HPV has been licensed for use in South Africa to reduce the incidence of HPV. The rationale for undertaking this research project was to establish the knowledge, awareness, and utilisation, of the HPV vaccine, among different healthcare workers. Method: Healthcare providers (100 general practitioners, 50 gynaecologists, 50 paediatricians, 50 medical staff and 50 nurses) working in the private sector, in the Ethekweni health district in KwaZulu-Natal, were interviewed. Comparisons of awareness among subgroups of healthcare providers were analysed. Associations between awareness and other factors were tested using a chi-square test. Results: Awareness of the vaccine was found to be 89% among healthcare workers,while 70.4% of practitioners informed patients of the availability of the HPV vaccine. Most practitioners (77.9%) have only prescribed the vaccine less than ten times. Gardasil® was prescribed by 46% of healthcare workers. In general, practitioners were unaware that Gardasil® could be prescribed to males (62.9%). Conclusion: Healthcare workers were aware of the HPV vaccine, and prescribed it on request. However, even though practitioners were aware of it, most prescribed it less than 10 times since it was licensed. Knowledge regarding the vaccine is deficient, as practitioners are unaware of its licensed use.
背景:人乳头瘤病毒(HPV)是宫颈癌、低级别宫颈病变和生殖道疣的病原体。自2008年3月以来,一种针对人乳头瘤病毒的疫苗已获准在南非使用,以减少人乳头瘤病毒的发病率。开展这项研究项目的基本原理是在不同的卫生保健工作者中建立人乳头瘤病毒疫苗的知识、意识和利用。方法:对夸祖鲁-纳塔尔省Ethekweni卫生区私营部门的保健提供者(100名全科医生、50名妇科医生、50名儿科医生、50名医务人员和50名护士)进行了访谈。比较医疗保健提供者亚组之间的意识进行了分析。意识与其他因素之间的关联采用卡方检验。结果:89%的卫生保健工作者了解HPV疫苗,而70.4%的从业人员告知患者HPV疫苗的可用性。大多数从业人员(77.9%)只开过不到10次疫苗。46%的医护人员开了加德西。总的来说,从业者不知道加德西®可以开给男性(62.9%)。结论:卫生保健工作者了解HPV疫苗,并根据要求开处方。然而,即使从业人员知道它,自它获得许可以来,大多数人开出的处方还不到10次。关于疫苗的知识不足,因为从业人员不知道其许可使用。
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引用次数: 3
Colonic metastasis from carcinoma cervix: an unusual cause of intestinal obstruction 宫颈癌结肠转移:一种罕见的肠梗阻病因
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441189
S. Prem, S. Gangothri, V. Parthasarathy, K. S. Reddy, D. Basu
Abstract Intestinal obstruction is a rare complication after pelvic radiotherapy for carcinoma cervix. Metastasis from carcinoma of the uterine cervix to the gastrointestinal tract is uncommon. We report a case of a 36-year-old woman who was treated by concurrent chemo-radiation for stage II B carcinoma of the uterine cervix. Five years later, she presented with acute intestinal obstruction. A laparotomy revealed a metastatic growth in the transverse colon, which was resected. The colon is an unusual site for metastasis from carcinoma cervix, and it has to be differentiated from a primary squamous cell carcinoma of the colon. Resection of the metastatic lesion may help palliate acute intestinal obstruction, and possibly prevent a perforation, which can rapidly become fatal.
摘要:肠梗阻是宫颈癌盆腔放疗后罕见的并发症。从子宫颈癌转移到胃肠道是罕见的。我们报告一例36岁的妇女谁是同时化疗放疗的II期B宫颈癌。五年后,她出现急性肠梗阻。剖腹手术发现横结肠有转移性生长,并予以切除。结肠是宫颈癌转移的罕见部位,必须与原发性结肠鳞状细胞癌鉴别。切除转移灶可能有助于缓解急性肠梗阻,并可能防止穿孔,这可能迅速成为致命的。
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引用次数: 2
Ovarian endometriosis as a premalignant condition: epidemiological, histological and molecular evidence 卵巢子宫内膜异位症作为恶性前病变:流行病学、组织学和分子证据
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441187
G. Dreyer
Abstract Endometriosis is a common monoclonal benign proliferative disorder that may give rise to pelvic malignancy. Epithelial ovarian carcinoma is responsible for a large proportion of gynaecological cancer-associated deaths. Early diagnosis is difficult and screening is generally unsuccessful. Knowledge of the risk factors for the development of endometriosis and progression to malignancy may assist in identifying women at risk of developing endometriosis-related neoplasia. The associations between infertility, endometriosis and the development of cancer are reviewed in this article. Proliferative growth, metaplasia, hyperplasia and atypia are identified as proliferative disorders in endometriosis and atypia is considered a premalignant lesion. Several endometriosis-related pelvic malignancies have been described, and these all develop from the multipotent Mullerian cell differentiating into epithelial and/or stromal components. The probable histological type depends on the site of the endometriotic lesion and the population group. Cytogenetic and specific gene alterations that are involved in the carcinogenetic process are described briefly and these may help to predict risk of malignancy or to confirm histological subtype. The importance of endometriosis as a precursor of ovarian and related malignancies was probably seriously underestimated in the past. Advances in molecular testing, histology and our understanding of oncogenesis may empower us to help prevent these devastating diseases.
子宫内膜异位症是一种常见的单克隆良性增生性疾病,可引起盆腔恶性肿瘤。上皮性卵巢癌在妇科癌症相关死亡中占很大比例。早期诊断困难,筛查通常不成功。了解子宫内膜异位症发展和恶性进展的危险因素可能有助于识别有发生子宫内膜异位症相关肿瘤风险的妇女。本文就不孕、子宫内膜异位症与癌症发展之间的关系进行综述。增殖性生长、化生、增生和异型性被认为是子宫内膜异位症的增殖性疾病,而异型性被认为是一种癌前病变。几种与子宫内膜异位症相关的盆腔恶性肿瘤已经被描述过,它们都是从多能缪勒管细胞分化为上皮和/或基质成分发展而来的。可能的组织学类型取决于子宫内膜异位病变的部位和人群。简述了参与癌变过程的细胞遗传学和特定基因改变,这些可能有助于预测恶性肿瘤的风险或确认组织学亚型。子宫内膜异位症作为卵巢及相关恶性肿瘤的前兆,其重要性在过去可能被严重低估。分子检测、组织学和我们对肿瘤发生的理解的进步可能使我们能够帮助预防这些毁灭性的疾病。
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引用次数: 1
About this issue... 关于这个问题……
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441184
G. Dreyer
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引用次数: 0
Sclerosing stromal tumour of the ovary 卵巢硬化性间质瘤
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441198
V. Fotedar, M. Gupta, R. Seam, A. Tiwari
Abstract Sclerosing stromal tumours (SSTs) are rare, benign, sex cord stromal tumours of the ovary. They affect women, who complain mainly of menstrual irregularity, in their second and third decades. We report a histologically confirmed case of a 23-year-old woman who presented with complaints of abdominal pain and irregular menstruation. She later underwent surgery when a pre-pathology workup raised the suspicion of a malignant tumour. It is imperative to consider the differential diagnosis of an SST of the ovary in a young woman with an ovarian tumour.
摘要硬化性间质瘤是一种罕见的良性卵巢性索间质瘤。他们影响的女性,主要抱怨月经不规律,在他们的第二和第三个十年。我们报告一例组织学确诊的23岁女性,主诉腹痛和月经不调。她后来接受了手术,因为病理前检查怀疑是恶性肿瘤。有卵巢肿瘤的年轻女性必须考虑卵巢SST的鉴别诊断。
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引用次数: 2
Bilateral serous papillary cystadenofibroma of the ovaries in a young female 年轻女性双侧卵巢浆液乳头状囊腺纤维瘤
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2012-01-01 DOI: 10.1080/20742835.2012.11441199
M. Nisha, A. Garima, S. Sneh, R. Parveen
Serous tumours comprise one fourth of all ovarian tumours. Most occur in adults. We present a case of a 24-year-old woman with bilateral ovarian masses which appeared to be malignant on imaging and perioperatively. However, microscopy revealed benign serous cystadenofibromas of the ovaries. This case signifies the importance of microscopy in neoplasms that masquerade as malignant on imaging, perioperatively and grossly. Serous cystadenofibroma of the ovary is a relatively rare benign tumour of the ovary. 1 We present a case of bilateral ovarian serous papillary cystadenofibromas in a young female.
浆液性肿瘤占所有卵巢肿瘤的四分之一。大多数发生在成年人身上。我们报告一个24岁的女性双侧卵巢肿块,在影像学和围手术期表现为恶性。然而,显微镜检查显示卵巢良性浆液性囊腺纤维瘤。这个病例说明了显微镜检查在影像学、围手术期和肉眼上伪装成恶性肿瘤的重要性。浆液性卵巢囊腺纤维瘤是一种较为罕见的卵巢良性肿瘤。我们报告一例年轻女性双侧卵巢浆液乳头状囊腺纤维瘤。
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引用次数: 1
期刊
Southern African Journal of Gynaecological Oncology
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