Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the i...Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the implementation of various prevention and screening strategies. The causative agent linked to cervical development and its precursors is the human papillomavirus(HPV). Prevention and screening measures for cervical cancer are paramount because the ability to identify and treat the illness at its premature stage often disrupts the process of neoplasia. Cervical carcinogenesis can be the result of infections from multiple high-risk HPV types that act synergistically. This imposes a level of complexity to identifying and vaccinating against the actual causative agent. Additionally, most HPV infections spontaneously clear. Therefore, screening strategies should optimally weigh the benefits and risks of screening to avoid the discovery and needless treatment of transient HPV infections. This article provides an update of the preventative and screening methodsfor cervical cancer, mainly HPV vaccination, screening with Pap smear cytology, and HPV testing. It also provides a discussion of the newest United States 2012 guidelines for cervical cancer screening, which changed the age to begin and end screening and lengthened the screening intervals.展开更多
目的探讨血清磷脂酰肌醇蛋白聚糖-3(phosphatidylinositol proteoglycan-3,GPC-3)、前列腺酸性磷酸酶(prostatic acid phosphatase,PAP)、前列腺癌抗原-2(prostate cancer antigen-2,EPCA-2)及联合前列腺特异性抗原(prostatic specific ...目的探讨血清磷脂酰肌醇蛋白聚糖-3(phosphatidylinositol proteoglycan-3,GPC-3)、前列腺酸性磷酸酶(prostatic acid phosphatase,PAP)、前列腺癌抗原-2(prostate cancer antigen-2,EPCA-2)及联合前列腺特异性抗原(prostatic specific antigen,PSA)检测在前列腺癌中的诊断价值.方法选取确诊的78例前列腺癌患者(前列腺癌组)和50例良性前列腺增生患者(前列腺增生组)作为研究对象,并选取同期与之配对的80例男性健康体检者作为对照组.用酶联免疫吸附试验检测血清GPC-3、PAP和EPCA-2水平,用时间分辨荧光分析法检测血清PSA水平,并绘制受试者工作特征(ROC)曲线分析GPC-3、PAP、EPCA-2和PSA对前列腺癌的诊断价值.结果前列腺癌组、前列腺增生组和对照组血清GPC-3、PAP、EPCA-2和PSA依次降低,3组比较差异均有统计学意义(P<0.05).血清GPC-3、PAP、EPCA-2和PSA 4个单项指标对前列腺癌均有一定的诊断价值,其敏感度及特异度分别为62.48%、63.31%,64.82%、60.19%,66.55%、63.33%,68.15%、65.92%(P=0.041、0.045、0.038、0.024);但联合检测可明显提高其诊断效能,以GPC-3+PAP+EPCA-2+PSA联合检测效果最佳,其敏感度和特异度分别为95.78%和92.89%.结论血清GPC-3、PAP、EPCA-2及PSA对前列腺癌均有一定诊断价值,但联合检测可明显提高其诊断效果,尤以GPC-3、PAP、EPCA-2及PSA四者联合效能最佳.展开更多
Cervical cancer prevention requires a multipronged approach involving primary, secondary and tertiary prevention. The key element under primary prevention is human papilloma virus(HPV) vaccination. So far, only prophy...Cervical cancer prevention requires a multipronged approach involving primary, secondary and tertiary prevention. The key element under primary prevention is human papilloma virus(HPV) vaccination. So far, only prophylactic HPV vaccines which prevent HPV infection by one or more subtypes are commercially available. Therapeutic HPV vaccines which aid in clearing established infection are still under trial. Secondary prevention entails early detection of precancerous lesions and its success is determined by the population coverage and the efficacy of the screening technique. A number of techniques are in use, including cytology, visual inspection(using the naked eye, magnivisualizer, acetic acid and Lugol's iodine), HPV testing and a combination of these methods. Updated screening guidelines have been advocated by the American Cancer Society in light of the role of HPV on cervical carcinogenesis. Recent research has also focussed on novel biomarkers that can predict progression to cancer in screen positive women and help to differentiate those who need treatment from those who can be left for follow-up. Last but not the least, effective treatment of precancerous lesions can help to reduce the incidence of invasive cervical cancer and this constitutes tertiary prevention.A combination of these approaches can help to prevent the burden of cervical cancer and its antecedent morbidity and mortality, but all of these are not feasible in all settings due to resource and allocation constraints. Thus, all countries, especially low and middle income ones, have to determine their own cocktail of approaches that work before we can say with certainty that yes, cervical cancer can be prevented.展开更多
文摘Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the implementation of various prevention and screening strategies. The causative agent linked to cervical development and its precursors is the human papillomavirus(HPV). Prevention and screening measures for cervical cancer are paramount because the ability to identify and treat the illness at its premature stage often disrupts the process of neoplasia. Cervical carcinogenesis can be the result of infections from multiple high-risk HPV types that act synergistically. This imposes a level of complexity to identifying and vaccinating against the actual causative agent. Additionally, most HPV infections spontaneously clear. Therefore, screening strategies should optimally weigh the benefits and risks of screening to avoid the discovery and needless treatment of transient HPV infections. This article provides an update of the preventative and screening methodsfor cervical cancer, mainly HPV vaccination, screening with Pap smear cytology, and HPV testing. It also provides a discussion of the newest United States 2012 guidelines for cervical cancer screening, which changed the age to begin and end screening and lengthened the screening intervals.
文摘目的探讨血清磷脂酰肌醇蛋白聚糖-3(phosphatidylinositol proteoglycan-3,GPC-3)、前列腺酸性磷酸酶(prostatic acid phosphatase,PAP)、前列腺癌抗原-2(prostate cancer antigen-2,EPCA-2)及联合前列腺特异性抗原(prostatic specific antigen,PSA)检测在前列腺癌中的诊断价值.方法选取确诊的78例前列腺癌患者(前列腺癌组)和50例良性前列腺增生患者(前列腺增生组)作为研究对象,并选取同期与之配对的80例男性健康体检者作为对照组.用酶联免疫吸附试验检测血清GPC-3、PAP和EPCA-2水平,用时间分辨荧光分析法检测血清PSA水平,并绘制受试者工作特征(ROC)曲线分析GPC-3、PAP、EPCA-2和PSA对前列腺癌的诊断价值.结果前列腺癌组、前列腺增生组和对照组血清GPC-3、PAP、EPCA-2和PSA依次降低,3组比较差异均有统计学意义(P<0.05).血清GPC-3、PAP、EPCA-2和PSA 4个单项指标对前列腺癌均有一定的诊断价值,其敏感度及特异度分别为62.48%、63.31%,64.82%、60.19%,66.55%、63.33%,68.15%、65.92%(P=0.041、0.045、0.038、0.024);但联合检测可明显提高其诊断效能,以GPC-3+PAP+EPCA-2+PSA联合检测效果最佳,其敏感度和特异度分别为95.78%和92.89%.结论血清GPC-3、PAP、EPCA-2及PSA对前列腺癌均有一定诊断价值,但联合检测可明显提高其诊断效果,尤以GPC-3、PAP、EPCA-2及PSA四者联合效能最佳.
文摘Cervical cancer prevention requires a multipronged approach involving primary, secondary and tertiary prevention. The key element under primary prevention is human papilloma virus(HPV) vaccination. So far, only prophylactic HPV vaccines which prevent HPV infection by one or more subtypes are commercially available. Therapeutic HPV vaccines which aid in clearing established infection are still under trial. Secondary prevention entails early detection of precancerous lesions and its success is determined by the population coverage and the efficacy of the screening technique. A number of techniques are in use, including cytology, visual inspection(using the naked eye, magnivisualizer, acetic acid and Lugol's iodine), HPV testing and a combination of these methods. Updated screening guidelines have been advocated by the American Cancer Society in light of the role of HPV on cervical carcinogenesis. Recent research has also focussed on novel biomarkers that can predict progression to cancer in screen positive women and help to differentiate those who need treatment from those who can be left for follow-up. Last but not the least, effective treatment of precancerous lesions can help to reduce the incidence of invasive cervical cancer and this constitutes tertiary prevention.A combination of these approaches can help to prevent the burden of cervical cancer and its antecedent morbidity and mortality, but all of these are not feasible in all settings due to resource and allocation constraints. Thus, all countries, especially low and middle income ones, have to determine their own cocktail of approaches that work before we can say with certainty that yes, cervical cancer can be prevented.
