Epidemiologie, Prävention und Früherkennung des Zervixkarzinoms

Wentzensen, Nicolas

doi:10.1007/s00761-016-0092-7

Cited by 14 publications

(6 citation statements)

References 45 publications

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“…High-risk HPV infection has been recognized as a necessary condition for the occurrence and development of cervical squamous epithelial lesions and cervical cancer [ 19 ]. In this study, the rate of high-risk HPV infection in women with positive margins after CKC was 83.50% (268/321).…”

Section: Discussionmentioning

confidence: 99%

Necessity for subsequent surgery in women of child-bearing age with positive margins after conization

Wang

Gao

et al. 2021

BMC Women's Health

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Background 20–25% of women with high-grade cervical intraepithelial neoplasias (HSIL) have residual lesions after conization. The state of the margin is generally considered to be a risk factor for recurrence or persistent lesions. Predictors of positive margins and residual lesions need to be identified. A design for postoperative management and avoidance of overtreatment needs to be provided, especially for women of child-bearing age. Methods This study was a retrospective analysis of 1309 women of child-bearing age with HSIL, who underwent cold knife conization (CKC). Age, gravidity, parity, human papillomavirus (HPV) species, cytology, transformation zone type, results of endocervical curettage (ECC), quadrant involvement, glandular involvement, and Cervical Intraepithelial Neoplasia (CIN) grade were analyzed. Among those with positive margins, 245 patients underwent secondary surgery within three months, including CKC, a loop electrosurgical excision procedure, and total hysterectomy. Risk factors for positive margins and residual lesions were assessed. Results There was no significant difference in age, gravidity, parity, glandular involvement, and CIN grade between the two groups (P > 0.3). There was a significant difference in HPV species, cytology, ECC results, and quadrant involvement (P < 0.002). Multivariate analysis showed a major cytology abnormality, high-risk HPV infection, type III transformation zone, positive ECC result, and multiple quadrant involvement were independent risk factors for positive margins and residual lesions (P < 0.02). Age > 35 years was also a risk factor for residual lesions (P < 0.03). Conclusion High-risk women should be treated appropriately considering fertility. Patients with positive margins should be managed uniquely. Surgery for women without fertility may be appropriate. Close follow-up is necessary for women who have fertility requirements or are unwilling to undergo subsequent surgery if they have no risk factors, especially women < 35 years.

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Section: Discussionmentioning

confidence: 99%

Necessity for subsequent surgery in women of child-bearing age with positive margins after conization

Wang

Gao

et al. 2021

BMC Women's Health

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“…Studies have shown that the percentage of HSIL detected by cervical curettage in postmenopausal patients (9.9%) is higher than that in premenopausal patients (2.6%) [28]. Combined with the HR-HPV test, it can provide better cervical cancer protection for postmenopausal patients than a simple TCT test [29]. Therefore, we compared the difference between premenopausal and postmenopausal patients with HPV E6/E7 mRNA detection.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of high-risk HPV E6/E7 mRNA in patients with ASCUS Analysis of pathogenicity of HPV in patients with ASCUS

Jin

Liu

Zhang

et al. 2023

Preprint

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Objective: To investigate the infection status of high-risk human papillomavirus (HR-HPV) E6/E7 mRNA in patients with a cytological diagnosis of "atypical squamous cells of undetermined significance" (ASCUS) and to analyze the pathogenic rate of different high-risk HPV subtypes combined with biopsy pathological results to provide a more accurate basis for managing ASCUS patients. Methods A total of 1387 patients with ASCUS and HPV E6/E7 mRNA positivity who were referred for colposcopy were retrospectively analyzed. They were divided into HPV16+, 18/45+ and other HR-HPV+ groups premenopausal and postmenopausal groups. The pathological results of the biopsy were divided into the LSIL- group (including normal and low-grade squamous intraepithelial lesions) and the HSIL+ group (including high-grade squamous intraepithelial lesions and higher lesions). SPSS was used for the analysis. Results The age group 31-40 years had the highest level of HPV16+, and HPV18/45+ was the highest in the 41-50 years group. The detection rates of HSIL+ in the HPV16+, HPV18/45+, HPV 16/18/45+ and Other HR-HPV+ groups were 48.4%, 18.8%, 43.9% and 15.0%, respectively. The infection rates of HPV16/18/45 in postmenopausal and premenopausal women were 42.4% and 34.3%, respectively. In the HPV18/45 group, the incidence of HSIL+ was 30.0% in postmenopausal women and 15.0% in premenopausal women (P < 0.01). In the HPV 16+ and Other HR-HPV+ groups, the incidence of HSIL+ in postmenopausal patients was not significantly different from that in premenopausal patients. The incidence of cervical cancer in postmenopausal patients is significantly higher than that in premenopausal patients. Conclusions Colposcopy referral or further biopsy is recommended for all ASCUS patients with HPV16/18/45E6/E7 mRNA positivity and postmenopausal patients with HR-HPVE6/E7 mRNA positivity. For premenopausal ASCUS patients with other HR-HPV E6/E7 mRNA positivity, colposcopy should be performed if possible, depending on the specific situation, to achieve early detection and diagnosis.

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“…For instance, aberrant expression of EP2 has been found to be associated with chronic inflammation, deregulation of the immune system, angiogenesis, metastasis as well as multidrug resistance and has been observed in cancer of the colon, liver, breast and cervix (Asting et al 2017 ; Cui et al 2017 ; Gong et al 2017 ; Huynh 2017 ). Besides the impact of EP2 activation on cell proliferation in cervical squamous intraepithelial lesions the immunosuppressive effect of EP2 seems of interest, as only HPV infections which are not cleared by the immune system can cause SILs and cervical cancer (Westrich et al 2017 ).…”

Section: Discussionmentioning

confidence: 99%

“…260,000 women die from the disease each year (Gottlieb 2016;Jiang et al 2015;Landy et al 2016). Incidence and mortality of cervical cancer correlates negatively with the Human Development Index and varies extremely in geographic contexts (Wentzensen 2016). Regarding Germany, 4500 women were diagnosed with cervical cancer in 2014 and 1500 of these patients died tumour associated (Zentrum fur Krebregisterdaten 2019).…”

Section: Introductionmentioning

confidence: 99%

The role of EP-2 receptor expression in cervical intraepithelial neoplasia

Schmoeckel

Fraungruber

Kühn

et al. 2020

Histochem Cell Biol

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Prostaglandin induced signalling is involved in different cancers. As previously described, the EP3 receptor expression decreases with increasing stage of cervical intraepithelial lesions (CIN). In addition, in cervical cancer EP3 is an independent prognosticator for overall survival and correlates with FIGO stages. Currently the role of Prostaglandin 2 receptor 2 (EP2) in CIN is unknown. The aim of this study was to analyse the expression of EP2 for potential prognostic value for patients with cervical dysplasia. EP2 expression was analysed by immunohistochemistry in 33 patient samples (CIN1-3) using the immune-reactivity scoring system (IRS). Expression levels were correlated with clinical outcome to analyse prognostic relevance in patients with CIN2. Data analysis was performed using non parametric Kruskal-Wallis and Spearman rank sum test. Cytoplasmic expression levels of EP2 correlated significantly (p < 0.001) with different grades of cervical dysplasia. Median EP2-IRS in CIN1 was 2 (n = 8), 3 in CIN2 (n = 9) and 6 in CIN3 (n = 16). Comparing regressive (n = 3, median IRS = 2) to progressive (n = 6, median IRS = 4) CIN2 cases the median IRS differed significantly (p = 0.017). Staining intensity (p = 0.009) and IRS (p = 0.005) of EP2 and EP3 correlate inversely. EP2 expression level significantly increases with higher grade of CIN and could qualify as a potential prognostic marker for the regressive or progressive course in CIN2 lesions. These findings emphasize the significant role of PGE2 signalling in CIN and could help to identify targets for future therapies.

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Epidemiologie, Prävention und Früherkennung des Zervixkarzinoms

Cited by 14 publications

References 45 publications

Necessity for subsequent surgery in women of child-bearing age with positive margins after conization

Necessity for subsequent surgery in women of child-bearing age with positive margins after conization

Diagnostic value of high-risk HPV E6/E7 mRNA in patients with ASCUS Analysis of pathogenicity of HPV in patients with ASCUS

The role of EP-2 receptor expression in cervical intraepithelial neoplasia

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