Cervical Precancerous Lesions Research Articles

Exposure to polycyclic aromatic hydrocarbons promotes the progression of low-grade cervical intraepithelial neoplasia: A population-based cohort study in China.

Low-grade cervical intraepithelial neoplasia (CIN1) is an early stage of cervical cancer development. Previously, we reported that exposure to polycyclic aromatic hydrocarbons (PAHs) increases the risk of cervical precancerous lesions, especially in females with a high-risk human papillomavirus (HR-HPV) infection. However, the effects of PAHs on CIN1 progression remain unclear. A community-based prospective cohort study was conducted to evaluate the role of exposure to PAHs in the progression of CIN1. A total of 564 patients diagnosed with CIN1 were followed-up at 6, 12, and 24 months, post-diagnosis, to determine CIN1 reversion, persistence, and progression. Exposure to PAHs was determined by the urine 1-hydroxipayrene (1-OHP) level. Our results showed that the 1-OHP level was significantly higher in patients with CIN1 persistence/progression than in those with reversion (P < .05). High exposure to PAHs increased the risk of CIN1 persistence/progression, with hazard ratios (HR), 95% confidence intervals (CI) of (1.62, 1.24-2.67), (1.98, 1.42-2.75), and (2.37, 1.61-3.49) at 6, 12, and 24 months, post-diagnosis, respectively. The effect was enhanced with HR-HPV positivity, as determined at 6 (1.82, 1.24-2.67), 12 (3.02, 1.74-5.23), and 24 (2.51, 1.48-4.26) months, post-diagnosis. Moreover, the predictive value of exposure to PAHs for CIN1 persistence/progression was higher in HR-HPV-positive patients than in HR-HPV-negative patients. The results revealed that exposure to PAHs facilitated the malignant progression of CIN1 and hindered its reversal, particularly in patients with HR-HPV infection. Our findings provide novel insights into early prevention and intervention targeting the initiation and progression of cervical neoplasia.

Female genital schistosomiasis burden and risk factors in two endemic areas in Malawi nested in the Morbidity Operational Research for Bilharziasis Implementation Decisions (MORBID) cross-sectional study.

Female genital schistosomiasis (FGS), caused by the parasite Schistosoma haematobium (Sh), is prevalent in Sub-Saharan Africa. FGS is associated with sexual dysfunction and reproductive morbidity, and increased prevalence of HIV and cervical precancerous lesions. Lack of approved guidelines for FGS screening and diagnosis hinder accurate disease burden estimation. This study evaluated FGS burden in two Sh-endemic areas in Southern Malawi by visual and molecular diagnostic methods. Women aged 15-65, sexually active, not menstruating, or pregnant, were enrolled from the MORBID study. A midwife completed a questionnaire, obtained cervicovaginal swab and lavage, and assessed FGS-associated genital lesions using hand-held colposcopy. 'Visual-FGS' was defined as specific genital lesions. 'Molecular-FGS' was defined as Sh DNA detected by real-time PCR from swabs. Microscopy detected urinary Sh egg-patent infection. In total, 950 women completed the questionnaire (median age 27, [IQR] 20-38). Visual-and molecular-FGS prevalence were 26·9% (260/967) and 8·2% (78/942), respectively. 6·5% of women with available genital and urinary samples (38/584) had egg-patent Sh infection. There was a positive significant association between molecular- and visual-FGS (AOR = 2·9, 95%CI 1·7-5·0). 'Molecular-FGS' was associated with egg-patent Sh infection (AOR = 7·5, 95% CI 3·27-17·2). Some villages had high 'molecular-FGS' prevalence, despite <10% prevalence of urinary Sh among school-age children. Southern Malawi carries an under-recognized FGS burden. FGS was detectable in villages not eligible for schistosomiasis control strategies, potentially leaving girls and women untreated under current WHO guidelines. Validated field-deployable methods could be considered for new control strategies.

Precancerous lesion determinants in women attending cervical cancer screening at public health facilities in North Shoa Zone, Amhara, Ethiopia: an unmatched case-control study

BackgroundPrecancerous cervical lesions develop in the transformation zone of the cervix and progress through stages known as cervical intraepithelial neoplasia (CIN) 1, 2, and 3. If untreated, CIN2 or CIN3 can lead to cervical cancer. The determinants of cervical precancerous lesions are not well documented in Ethiopia. Therefore, this study aims to find the determinants of cervical precancerous lesions among women screened for cervical cancer at public health facilities.MethodsA study conducted from January to April 2020 involved 216 women, consisting of 54 cases (positive for VIA during cervical cancer screening) and 162 controls (negative for VIA). It focused on women aged 30 to 49 undergoing cervical cancer screening. Multivariable logistic regression analysis assessed the link between precancerous lesions and different risk factors, considering a significance level of p < 0.05.ResultsWomen who used oral contraceptives for a duration exceeding five years showed a nearly fivefold increase in the likelihood of developing precancerous lesions (Adjusted Odds Ratio (AOR) = 4.75; 95% CI: 1.48, 15.30). Additionally, early age at first sexual intercourse (below 15 years) elevated the odds of developing precancerous lesions fourfold (AOR = 3.77; 95% CI: 1.46, 9.69). Furthermore, women with HIV seropositive results and a prior history of sexually transmitted infections (STIs) had 3.4 times (AOR = 3.45; 95% CI: 1.29, 9.25) and 2.5 times (AOR = 2.58; 95% CI: 1.10, 6.09) higher odds of developing cervical precancerous lesions compared to their counterparts.ConclusionIn conclusion, women who have used oral contraceptives for over five years, started sexual activity before the age of 15 and have a history of sexually transmitted infections, including HIV, are at higher risk of developing precancerous cervical lesions. Targeted intervention strategies aimed at promoting behavioural change to prevent early sexual activity and STIs are crucial for avoiding cervical precancerous lesions. It is crucial to introduce life-course principles for female adolescents early on, acknowledging the potential to prevent and control precancerous lesions at critical stages in life, from early adolescence to adulthood, encompassing all developmental phases.

Analysis of the diagnostic performance of PAX1/SOX1 gene methylation in cervical precancerous lesions and its role in triage diagnosis.

Methylation panels, tools for investigating epigenetic changes associated with diseases like cancer, can identify DNA methylation patterns indicative of disease, providing diagnostic or prognostic insights. However, the application of methylation panels focusing on the sex-determining region Y-box 1 (SOX1) and paired box gene 1 (PAX1) genes for diagnosing cervical lesions is under-researched. This study aims to examine the diagnostic performance of PAX1/SOX1 gene methylation as a marker for cervical precancerous lesions and its potential application in triage diagnosis. From September 2022 to April 2023, 181 patients with abnormal HPV-DNA tests or cytological exam results requiring colposcopy were studied at Hubei Maternal and Child Health Hospital, China. Data were collected from colposcopy, cytology, HPV-DNA tests, and PAX1/SOX1 methylation detection. Patients were categorized as control, cervical intraepithelial neoplasia Grade 1 (CIN1), Grade 2 (CIN2), Grade 3 (CIN3), and cervical cancer (CC) groups based on histopathology. We performed HPV testing, liquid-based cytology, and PAX1/SOX1 gene methylation testing. We evaluated the diagnostic value of methylation detection in cervical cancer using DNA methylation positivity rate, sensitivity, specificity, and area under the curve (AUC), and explored its potential for triage diagnosis. PAX1/SOX1 methylation positivity rates were: control 17.1%, CIN1 22.5%, CIN2 100.0%, CIN3 90.0%, and CC 100.0%. The AUC values for PAX1 gene methylation detection in diagnosing CIN1+, CIN2+, and CIN3+ were 0.52 (95% confidence interval [CI]: 0.43-0.62), 0.88 (95% CI: 0.80-0.97), and 0.88 (95% CI: 0.75-1.00), respectively. Corresponding AUC values for SOX1 gene methylation detection were 0.47 (95% CI: 0.40-0.58), 0.80 (95% CI: 0.68-0.93), and 0.92 (95% CI: 0.811-1.00), respectively. In HPV16/18-negative patients, methylation detection showed sensitivity of 32.4% and specificity of 83.7% for CIN1+. For CIN2+ and CIN3+, sensitivity was all 100%, with specificities of 83.0% and 81.1%. Among the patients who underwent colposcopy examination, 166 cases had cytological examination results ≤ASCUS, of which 37 cases were positive for methylation, and the colposcopy referral rate was 22.29%. PAX1/SOX1 gene methylation detection exhibits strong diagnostic efficacy for cervical precancerous lesions and holds significant value in triage diagnosis.

Research Progress of Natural Source Potential Drugs in Reversing Cervical Precancerous Lesions and Human Papillomavirus Negative Conversion

The recent breakthrough in understanding the etiology of cervical cancer has led to increased attention towards the prevention and treatment of this disease. Extensive research has confirmed a strong correlation between persistent infection of the human papillomavirus (HPV) and the development of cervical cancer. Focusing on the pivotal role of HPV infection in the occurrence and progression of cervical cancer, there has been a surge in research aimed at developing drugs that can eradicate HPV and reverse cervical precancerous lesions. Natural drugs have attracted considerable attention in the field of tumor therapy due to their multi-targeted approach, high selectivity, and low toxic and side effects. Therefore, this paper aims to review the research progress of natural drugs in the treatment of HPV infection and cervical precancerous lesions, while also exploring their pharmacological mechanism. The goal is to provide comprehensive information basis for the potential application of natural drugs in the prevention and treatment of cervical cancer.

Changes in intrahost genetic diversity according to lesion severity in longitudinal HPV16 samples.

Human papillomavirus type 16 (HPV16) is the most common cause of cervical cancer, but most infections are transient with lesions not progressing to cancer. There is a lack of specific biomarkers for early cancer risk stratification. This study aimed to explore the intrahost HPV16 genomic variation in longitudinal samples from HPV16-infected women with different cervical lesion severity (normal, low-grade, and high-grade). The TaME-seq deep sequencing protocol was used to generate whole genome HPV16 sequences of 102 samples collected over time from 40 individuals. Single nucleotide variants (SNVs) and intrahost SNVs (iSNVs) were identified in the viral genomes. A majority of individuals had a unique set of SNVs and these SNVs were stable over time. Overall, the number of iSNVs and APOBEC3-induced iSNVs were significantly lower in high-grade relative to normal and low-grade samples. A significant increase in the number of APOBEC3-induced iSNVs over time was observed for normal samples when compared to high-grade. Our results indicates that the lower incidence of iSNVs and APOBEC3-induced iSNVs in high-grade lesions may have implications for novel biomarkers discoveries, potentially aiding early stratification of HPV-induced cervical precancerous lesions.

Detection of cervical precancerous lesions and cancer by qPCR-based analysis of the reciprocally expressed mRNA pairs in cytological smears

Detection of cervical precancerous lesions and cancer by qPCR-based analysis of the reciprocally expressed mRNA pairs in cytological smears

Cervicovaginal microbiota: a promising direction for prevention and treatment in cervical cancer.

Cervical cancer is a common malignancy in women, with high incidence rate and mortality. Persistent infection of high-risk human papillomavirus (HPV) is the most important risk factor for cervical cancer and precancerous lesions. Cervicovaginal microbiota (CVM) plays an essential role in the defense of HPV infections and prevention of subsequent lesions. Dominance of Lactobacillus is the key of CVM homeostasis, which can be regulated by host, exogenous and endogenous factors. Dysbiosis of CVM, including altered microbial, metabolic, and immune signatures, can contribute to persist HPV infection, leading to cervical cancer. However, there is no evidence of the causality between CVM and cervical cancer, and the underlying mechanism remains unexplored. Considering the close correlation between CVM dysbiosis and persistent HPV infection, this review will overview CVM, its role in cervical cancer development and related mechanisms, and the prospects for therapeutic applications.

Prevalence of High-Risk Human Papillomavirus Infection, Associated Risk Factors, and Relationship With Cervical Precancerous Lesions in Perimenopausal and Older Women in an Area With High Cervical Cancer Incidence in China.

Purpose This study delves into the epidemiology of high-risk human papillomavirus (HR-HPV) infection and its link to precancerous lesions among perimenopausal (40-59 years) and elderly (60-65 years) women in a Chinese county with a notably high incidence of cervical cancer. By uniquely focusing on these age groups in underdeveloped regions, the research aims to offer novel strategies for the management and prevention of cervical cancer. It seeks to inform targeted interventions and public health policies that could significantly benefit women at heightened risk for HPV, addressing a critical gap in current prevention efforts in economically disadvantaged communities. Methods This observational study was conducted at the Maternal and Child Health and Family Planning Service Centre in Lueyang County, from September 2021 to January 2022. It assessed 2008 women aged 40-65 for HPV screening, with 342 undergoing further cytological examination. The study evaluated the prevalence of HPV infection across different age groups and risk categories. It utilized a questionnaire to collect participants' basic information, health behaviors, and other relevant data to analyze factors influencing HR-HPV infection. Statistical analyses comprised chi-square tests, trend analysis, logistic regression, and multiple imputation techniques to address missing data. Results The prevalence of HR-HPV infection among women aged 40-65 years in Lueyang County was 18.43%. Older women exhibited a higher incidence of HPV infection, abnormal ThinPrep Cytology Test (TCT) results (Shaanxi Fu'an Biotechnology Co.Ltd., Baoji City, China), and low/high-grade squamous intraepithelial lesions (LSIL/HSIL) (P<0.05). The most prevalent HR-HPV genotypes in the overall, perimenopausal, and elderly groups were HPV-52, -53, and -58; HPV-52, -53, and -16; and HPV-58, -52, and -53, respectively. The prevalent HR-HPV genotypes in the abnormal The Bethesda System (TBS) results were HPV-16, -52, -33, -58; -16, -52, -58; and-16, -33, and -52. HPV-16, -18, -33 prevalence increased with increasing lesion severity (P<0.05). In this study, factors affecting HR-HPV in the three age groups were found to be mainly related to sexual behavior and education level, including history of lower genital tract diseases, multiple pregnancies, contraceptive methods without tubal ligation, age at first marriage greater than 18 years, never washing the vulva after sex, abstinence from sex, education level of junior high school or above, and spouse's education level of high school or above. Conclusions These findings suggest that the elevated rate of abnormal TBS in the older age group may be attributed to the higher prevalence of persistent infection-prone HR-HPV genotypes (HPV-58, -52, and-53), multiple infections, and potent oncogenic HR-HPV genotypes (HPV-16 and -33). Additionally, the higher HR-HPV prevalence in older patients may be related to lower education attainment, reduced screening rate, and limited condom usage. Therefore, strategies targeting perimenopausal and older women should prioritize enhancing health awareness, increasing screening rates, and encouraging condom utilization.

Analysis of related factors for pathological upgrading of cervical biopsy from CIN3 to cancer after conical resection

BackgroundTo investigate related factors for postoperative pathological upgrading of cervical biopsy to cervical cancer (CC) in patients with cervical intraepithelial neoplasia (CIN)3 after conical resection.MethodsThis retrospective study collected data from patients diagnosed with CIN3 by cervical biopsies at the author’s Hospital between January 2012 and December 2022. The primary outcome was the pathological results of patients after conical resection. The pathological findings were categorized into the pathological upgrading group if postoperative pathology indicated CC, while those with normal, inflammatory, or cervical precancerous lesions were classified into the pathological non-upgrading group. The factors associated with upgrading were identified using multivariable logistic regression analysis.ResultsAmong 511 patients, there were 125 patients in the pathological upgrading group (24.46%). The patients in the upgrading group were younger (47.68 ± 9.46 vs. 52.11 ± 7.02, P < 0.001), showed a lower proportion of menopausal women (38.40% vs. 53.02%, P = 0.0111), a lower proportion of HSIL (40.00% vs. 57.77%, P = 0.001), a higher rate of HPV-16/18 positive (25.60% vs. 17.36%, P = 0.011), a higher rate of contact bleeding (54.40% vs. 21.50%, P < 0.001), lower HDL levels (1.31 ± 0.29 vs. 1.37 ± 0.34 mmol/L, P = 0.002), higher neutrophil counts (median, 3.50 vs. 3.10 × 109/L, P = 0.001), higher red blood cell counts (4.01 ± 0.43 vs. 3.97 ± 0.47 × 1012/L, P = 0.002), higher platelet counts (204.84 ± 61.24 vs. 187.06 ± 73.66 × 109/L, P = 0.012), and a smaller platelet volume (median, 11.50 vs. 11.90 fL, P = 0.002).The multivariable logistic regression analysis showed that age (OR = 0.90, 95% CI: 0.86–0.94, P < 0.001), menopausal (OR = 2.68, 95% CI: 1.38–5.22, P = 0.004), contact bleeding (OR = 4.80, 95% CI: 2.91–7.91, P < 0.001), and mean platelet volume (OR = 0.83, 95% CI: 0.69–0.99, P = 0.038) were independently associated with pathological upgrading from CIN3 to CC after conical resection.ConclusionAge, menopausal, contact bleeding, and mean platelet volume are risk factors of pathological upgrading from CIN3 to CC after conical resection, which could help identify high risk and susceptible patients of pathological upgrading to CC.

Therapeutic Effect Analysis of Cervical Cancer Vaccine

Cervical cancer is a very widespread carcinogenic condition that poses a significant threat to women's health. The primary cause of this condition is mostly linked to persistent infection with high-risk strains of human papillomavirus (HPV), which are recognized for their ability to promote the development of cancer. Due to HPV infection, both therapeutic and preventative HPV vaccinations have been developed. Therapeutic vaccines can eradicate viruses and virus-infected cells by stimulating cellular immunity. Notwithstanding the availability of preventive HPV vaccinations, HPV screening, surgery, radiotherapy, and chemotherapy, the therapeutic effect on cervical cancer patients is limited. Therefore, therapeutic vaccines have emerged as a new treatment option. The cancer-causing proteins E6 and E7, which are consistently detected in cervical cancer and precancerous lesions, are crucial in the progression and sustenance of cervical cancer. Consequently, these cancer-causing proteins present an encouraging opportunity for the research and creation of therapeutic cervical cancer vaccines. The multiple therapeutic vaccines against cervical cancer will be briefly discussed in this article, including their mechanisms, development methods, and clinical effects.

Application of different methods for cervical cancer detection

Cervical cancer remains a widespread and challenging malignancy that affects women worldwide and poses significant clinical and public health issues. Since it is difficult to find early cervical lesions in the patient's own state, it is very important to apply appropriate and effective detection and screening for cervical cancer and precancerous lesions. This research investigates the development of cervical cancer and the various subtypes of HPV, which are the primary cause of cervical lesions. Combined with the investigation of the three most common clinical screening methods, including liquid-based thin-layer cell assay (TCT), human papillomavirus detection (HPV) and colposcopy detection operating methods and screening standards, data were used to comprehensively analyze the accuracy, sensitivity and specificity of single or combined screening of the three detection methods. This research examines various methods and technologies for cervical cancer screening, with the goal of determining their clinical effectiveness in detecting cervical lesions. Based on screening data, the results are positive and the methods are deemed suitable for early diagnosis of the condition. It is recommended that these screening tools be utilized in a clinical setting.

FMA-Net: Fusion of Multi-Scale Attention for Grading Cervical Precancerous Lesions

Cervical cancer, as the fourth most common cancer in women, poses a significant threat to women’s health. Vaginal colposcopy examination, as the most cost-effective step in cervical cancer screening, can effectively detect precancerous lesions and prevent their progression into cancer. The size of the lesion areas in the colposcopic images varies, and the characteristics of the lesions are complex and difficult to discern, thus heavily relying on the expertise of the medical professionals. To address these issues, this paper constructs a vaginal colposcopy image dataset, ACIN-3, and proposes a Fusion Multi-scale Attention Network for the detection of cervical precancerous lesions. First, we propose a heterogeneous receptive field convolution module to construct the backbone network, which utilizes combinations of convolutions with different structures to extract multi-scale features from multiple receptive fields and capture features from different-sized regions of the cervix at different levels. Second, we propose an attention fusion module to construct a branch network, which integrates multi-scale features and establishes connections in both the spatial and channel dimensions. Finally, we design a dual-threshold loss function and introduce positive and negative thresholds to improve sample weights and address the issue of data imbalance in the dataset. Multiple experiments are conducted on the ACIN-3 dataset to demonstrate the superior performance of our approach compared to some classical and recent advanced methods. Our method achieves an accuracy of 92.2% in grading and 94.7% in detection, with average AUCs of 0.9862 and 0.9878. Our heatmap illustrates the accuracy of our approach in focusing on the locations of lesions.

The Role of HPV Genotype among Colposcopy Diagnosed Cervical Precancerous Lesions

Background: Cancer is the leading cause of death and a major contributor to reduced life expectancy in every country on Earth [1]. Cervical cancer (CC) is a serious global health concern that is more common in developing countries, especially those on the Indian subcontinent. More and more women are suffering from CC. Cervical cancer is mostly caused by the Human Papillomavirus (HPV), a sexually transmitted virus that is one of the most common illnesses of the reproductive system. Objective: The aim of this study is to evaluate the role of HPV genotype among colposcopy diagnosed cervical precancerous lesions. Methods: The cross-sectional observational study was conducted in the Department of Gynecological Oncology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2021 to June 2022. A total of 132 subjects were included in the study. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, the mean age was found to be 36.7±6.3 years, with a range from 31 to 60 years, the majority 53 (40.2%) of patients completed SSC and 118 (89.4%) were housewives and 125(94.7%) were Muslims. In this study most of the patients 101 (76.5%) came from middle-income families. About 45 (34.1%) patients were married between the ages of 15-17 years, 45 (34.1%) were between 16-18 years during their first delivery and 56 (42.4%) had 3-4 children. Most of the patients 92(69.7%) had history of received OCP. About 10(7.0%) patients were found HPV 16 positive followed by 1(0.7%) HPV 18, 3(2.1%) other HR-HPV, 3(2.1%) HPV 16 &amp; other HR-HPV and 1(0.7%) HPV 16-HPV 18 &amp; other HR-HPV. Most of the 95 (72.0%) patients had CIN I, 30 (22.7%) had CIN II and 7 (5.3%) had CIN III identification by colposcopy reports. In this study 59 (44.7%) patients had CIN I followed by 13 (9.8%) had CIN II, 9 (6.8%) had CIN III, 5 (3.8%) had CIS and 46 (34.8%) ..

Diagnostic Performance between Colposcopy Findings and Histopathology Reports

Background: Cervical cancer is the most frequent cancer in women worldwide. With appropriate screening, the condition can be prevented and treated. Colposcopy is a useful tool in the diagnosis and management of precancerous cervical lesions following primary screening. The gold standard for identifying precancerous lesions is histopathology. Objective: The aim of this study is to evaluate the diagnostic performance between colposcopy findings and histopathology reports Methods: The cross-sectional observational study was conducted in the Department of Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2022 to June 2023. A total of 62 subjects were included in the study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, the mean age was found to be 36.8±11.9 years, with a range from 20 to &gt;51 years maximum 44 (71.0%) of the patients were within the age group of 20 - 40 years. The majority 37 (59.7%) of patients completed SSC and most of the patients 56 (90.3%) were housewives. Most of the patients 59 (95.2%) were Muslims and about 32 (51.6%) came from middle-income families. About 25 (40.3%) patients were married between the ages of 15-17 years. About 25 (40.3%) were between 16-18 years during their first delivery and about 26 (41.9%) had 3-4 children and 21 (33.9%) had more than 4 children. Most of the patients 43(69.4%) had history of received OCP. Regarding colposcopic diagnosis, 12.9% (n=8) were normal, 69.4% (n=43) were CIN I, 9.7% (n=6) were CIN II and 8.1% (n=5) were CIN III and 30.6% (n=19) chronic cervicitis, 46.8% (n=29) CIN I, 6.5% (n=4) CIN II, 6.5% (n=4) CIN III, 4.8% (n=3) carcinoma in situ and 4.8% (n=3) were invasive squamous cell carcinoma by the histopathological diagnosis. Conclusion: Colposcopy had a rather high diagnostic accuracy for histopathologically verified precancerous cervical lesions. Even if the results of the screening tests are normal, patients who report with postcoital and postmenopausal bleeding should have colposcopies and biopsies. Colposcopy also has a high sensitivity, therefore it is simple to use the "see and treat" approach to lower dropout rates.

Correlation of VIA Positive Cases with Colposcopic and Histopathological Findings in Diagnosis of Precancerous Lesion of Cervix in A Tertiary Care Hospital

Background: Cervical cancer prevention strategies are evolving by integrating new screening modalities such as human papillomavirus (HPV) DNA testing and visual inspection with acetic acid (VIA). Colposcopy, as a diagnostic tool, plays a crucial role in the management of abnormal cytology smears, especially in developed countries. However, its utilization and efficacy in resource-limited settings like Bangladesh remain underexplored. Objective: This study aimed to assess the correlation between VIA positivity and colposcopic/histopathological findings in diagnosing precancerous cervical lesions among women in Bangladesh. Method: A cross-sectional study was conducted among 200 women aged 30-60 attending the Gynecology OPD of Dhaka Medical College and Hospital. VIA positivity was determined, and all positive cases underwent colposcopic evaluation. Histopathological examination was performed for tissue samples obtained during colposcopy. Result: Among the participants, 21% were VIA-positive. Colposcopic evaluation revealed inflammation (26.2%), CIN I (38.1%), CIN II (11.1%), CIN III (9.5%), and invasive carcinoma (9.5%). Histopathology findings included inflammation (28.6%), CIN I (40.5%), CIN II (7.1%), and invasive carcinoma (16.7%). True positive and false positive cases were identified, with percentages calculated accordingly. Conclusion: Detailed colposcopic evaluation with guided biopsy is crucial for detecting pre-invasive and early cervical cancer. Integrating colposcopy into screening programs in Bangladesh could significantly reduce morbidity and mortality among young women.

Efficacy and Safety of Thermocoagulation vs. Cryotherapy for Cervical Precancerous Lesions: A Systematic Review and Meta-Analysis

Efficacy and Safety of Thermocoagulation vs. Cryotherapy for Cervical Precancerous Lesions: A Systematic Review and Meta-Analysis

Evaluation of human papillomavirus type 16 viral load and genome physical status in Iranian women with cervical disease.

This study examined the viral load and physical status of the human papillomavirus 16 (HPV-16) genome in non-cancerous, precancerous and cancerous cervical lesions. Quantitative real-time PCR was performed to determine HPV-16 E2 and E6 viral load in 132 cervical specimens. E2/E6 viral load ratio was used to determine the physical status of HPV-16 genome. E2 gene viral load was a significant (P < 0.001) predicting biomarker in differentiating non-cancerous from precancerous and cancerous samples. E6 gene viral load was significantly different between the groups (P < 0.001). The specificity and sensitivity of E2 and E6 in distinguishing SCC samples were 100% and 95% respectively. HPV-16 viral load measured through E2 and E6 genes is a reliable indicator of lesion type.

Pap smear in Early Detection of Cervical Precancerous Lesions in Erbil

Background and objectives: Cervical cancer remains common. This may be because Iraq has no cervical cancer screening or human papilloma virus vaccination program. The goal of the study is to figure out how well the Pap smear works as a way to find cervical precancerous lesions also identify the prevalence of cervical cancer among women and to identify the potential risk factors for cervical cancer. Methods: A prospective cross-sectional study conducted using closed end questionnaire tool for the purpose of data collection which started from 1st of October 2021 until 1st of September 2022. Convenient type of sampling was used in collecting data which include 470 women attending to cervical screening unit in Maternity Teaching Hospital, Erbil, Kurdistan Region /Iraq. The questionnaire composed of two main parts including the socio-demographic data of the patients such as age, gender, occupation, education level, religion, income status, age at the marriage, duration of marriage…etc. The result of pap smear and cone biopsy performed during colposcopy procedure to match the accuracy of pap smear. Results: The findings revealed that 36% of the women aged between 40-49 years, the majority (80%) of them were married at the age of 15-24 years, 30% of their marriage lasted from 4-14 years, and most (72.6%) of them were housewives. The result of sensitivity, accuracy, positive and negative predicted value was equal to 45.6%, 97.7%, 80%, 89.9% respectively. The kappa test was 0.52 which indicate agreement between screening and gold standard test is a diagnosis of cervical cancer is still colposcopy-guided biopsy, which is then staged on the basis of the clinical examination and the outcome of imaging procedures, most obtained results were statistically significant. Conclusion: Pap smear had a lower sensitivity, but a higher specificity in the current study. The most common complaint of the women was post-coital bleeding. Severe acute cervicitis was the most common finding for the Pap smear.

Human Leucocyte Antigen Class II Risk and Protective Alleles in Women with Cervical Intraepithelial Neoplasia

Background: Persistent human papillomavirus (HPV) infection is a necessary cause for development of cervical precancerous lesions and cervical cancer, however, only a small percentage of women progress to cervical cancer. The local immune response, determined, among other factors, by Human Leucocyte Antigen (HLA) genes, is thought to be significant. Still the results of genome studies are inconsistent and differ between ethnical populations. The aim of the study was to assess an association between HLA-DQA1*; DQB1*; DRB1* allele’s genetic variants between women with cervical precancerous lesions and healthy controls in Latvia.Materials and methods: From January until April 2017 we enrolled 84 consecutive patients referred for colposcopy to Riga East University Hospital (Latvia) due to abnormal cervical cytology results. 57 women who came for a regular check-up and had normal cytology smears were included in the control group. Material from the cervix was taken for subsequent HLA genotyping of 13 DRB1*, 8 DQA1*, and 12 DQB1* alleles. Colposcopy was performed on all participants. In case of visual suspicion for CIN cervical biopsy was done.Results: There were 57 “no CIN” patients, 23 histologically proven CIN 1 and 61 CIN2+ cases in the study population. CIN2+ was more often associated with DQA1*0401 (OR 6.68, 95% CI 1.47-30.29, p=0.014), DRB*15 (OR 2.99, 95% CI 1.22-7.39, p=0.017), DQB1*0401 (OR 2.91, 95%CI 1.11-7.68, p=0.03), DQA1*0103 (OR 2.72, 95% CI 1.02-7.21, p=0.045), DRB1*11 (OR 2.42, 95% CI 1.10-5.33, p=0.029) and DQB1*0301 (OR 1.94, 95% CI 1.12-3.38, p=0.018). Women with “no CIN” more often had DQB1*0501 (OR 0.17, 95% CI 0.04-0.81, p=0.026), DRB1*16 (OR 0.21, 95% CI 0.06-0.78, p=0.019), DQA1*0301 (OR 0.35, 95% CI 0.14-0.87, p=0.024) and DRB1*14 (OR 0.59, 95% CI 0.01-0.46, p=0.007).Conclusions: In the current study we have demonstrated a strong association with risk and protective HLA class II alleles that are determined by the HLA-DRB1*; DQA1*; DQB1*.