Premalignant Research Articles

Diagnostic implications of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammatory index for gastric carcinoma.

The diagnosis of gastric carcinoma (GC) is essential for improving clinical outcomes. However, the biomarkers currently used for GC screening are not ideal. To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII) for GC. The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed. The information on peripheral blood platelet, neutrophil, and lymphocyte counts in each patient was collected, and the NLR, PLR, and SII levels of both groups were calculated. Additionally, multivariate logistic regression analysis was conducted, and the diagnostic implications of NLR, PLR, and SII in differentiating patients with precancerous gastric conditions, compared with those with GC, were analyzed through receiver operating characteristic (ROC) curves. The data indicated that NLR, PLR, and SII had abnormally increased levels in the patients with GC. Gender and body mass index were risk factors for the occurrence of GC. ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions, who were differentiated from those with GC, were 0.824, 0.787, and 0.842, respectively. NLR, PLR, and SII are all abnormally expressed in GC and have diagnostic implications, especially when used as joint indicators, in distinguishing patients with precancerous gastric conditions from those with GC.

Expression of Concern: Alterations of RASSF1A in Premalignant Cervical Lesions: Clinical and Prognostic Significance.

Expression of Concern: Alterations of RASSF1A in Premalignant Cervical Lesions: Clinical and Prognostic Significance.

Analysis of Risk Factors for Gastric Cancer and Precancerous Lesions: A Case-Control Study.

To investigate the correlation between gastric xanthoma (GX) and precancerous lesions (PCL) and gastric cancer (GC), and to explore other potential risk factors for PCL and GC in northwest China. A case-control study was conducted from September 2022 to September 2023 at Xijing Hospital, Air Force Medical University (Xi'an, Shaanxi Province, China). The patients who underwent gastroscopy were enrolled and divided into the chronic gastritis (CG) group (n = 423), PCL group (n = 422), and GC group (n = 415). The variables were selected through univariate analysis, including demographic information, dietary habits, lifestyle, gastroscopic findings, and Helicobacter pylori (H. pylori) infection. Multivariate logistic regression analysis was performed to analyze the factors associated with PCL and GC, and odds ratio (OR) and 95% confidence interval (CI) were calculated. GX was more prevalent in the PCL group (14.93%) and the GC group (19.76%) than in the CG group (6.15%). Multivariate analysis revealed that age ≥ 50 years, male gender, rural residence, H. pylori infection, family history of GC, GX, and hypertension were independent risk factors for GC and PCL. Furthermore, a diet high in salt and spice, coupled with daily intake of less than 100 g of fresh fruits, might be associated with the occurrence of GC. Age ≥ 50 years, male gender, rural residence, family history of GC and H. pylori infection, presence of GX, and a history of hypertension may be risk factors for PCL and GC.

Co-Delivery of Glycyrrhizin and Paclitaxel via Gelatin-Based Core-Shell Nanoparticles Ameliorates 1,2-Dimethylhydrazine-Induced Precancerous Lesions in Colon.

Colorectal cancer is a lethal malignancy that begins from acquired/inherent premalignant lesions. Thus, targeting these lesions at an early stage of the disease could impede the oncogenesis and maximize the efficacy. The present work underscores a combinatorial therapy of paclitaxel (PTX) and glycyrrhizin (GL) delivered via gelatin-derived core-shell nanoparticles [AC-PCL(GL + PTX)-GNPs] for effective management of precancerous lesions. The desolvation method was adopted to prepare GL-loaded gelatin nanoparticles (GL-GNPs), which were coated with PTX and AC-PCL. The prepared NPs exhibited optimal physical attributes and had spherical morphology, as analyzed by transmission electron microscopy and field-emission scanning electron microscopy. In vitro release studies revealed sustained release for ∼96 h. Cell culture studies in HTC 116, and HT-29 cells showed synergistic action with CI < 0.9 and DRI > 1. Moreover, AC-PCL(GL + PTX)-GNPs exhibited amplified intracellular uptake and thus significantly reduced IC50. Pharmacokinetic studies revealed substantiated pharmacokinetic parameters (AUC0-∞, Cmax, etc.). In vivo studies in a 1,2-dimethyl hydrazine-induced model revealed a decrease in the number of lesions, mucin depletion, and subside infiltrations. An immunohistochemical study revealed elevated expression of caspase-9 and suppressed expression of VEGF and Ki-67. Toxicity studies showed insignificant changes in systemic biomarkers along with no alterations in organ morphology and hemocompatibility. In essence, AC-PCL(GL + PTX)-GNPs render a competent and safer tactic to regulate early-stage precancerous lesions.

Hereditary colorectal cancer syndromes and inflammatory bowel disease: results from a registry-based study

PurposeIn this study, we investigated the progression of high-grade dysplasia (HGD)/CRC in patients with hereditary colorectal cancer syndromes (HCSS) and concomitant inflammatory bowel diseases (IBDs).MethodsWe described the natural history of a series of patients with confirmed diagnosis of hereditary colorectal cancer syndromes (HCCSs) and concomitant IBDs who were referred to the Hereditary Digestive Tumors Registry at the Fondazione IRCCS Istituto Nazionale dei Tumori of Milan.ResultsBetween January 1989 and April 2024, among 450 patients with APC-associated polyposis and 1050 patients with Lynch syndrome (LS), we identified six patients with IBDs (five with UC, one with ileal penetrating CD) and concomitant HCCSs (five with LS, one with APC-associated polyposis). Three patients developed CRC (two patients with stage IIA, and one with stage IIIA); in one patient, CRC occurred over a median follow-up of 12 months after IBD diagnosis, while in two, both conditions were diagnosed simultaneously. The median age at initial diagnosis of CRC was 33 years (range 27–41). Five patients (83.3%) underwent surgical procedures (three colonic resections for carcinoma and two for other reasons). Most of them progressed to precancerous or cancerous colonic lesions at a young age. Notably, all patients with CRC had a diagnosis of UC.ConclusionIBD patients with coexistent HCCSs can develop early CRC onset at an advanced stage. These patients should be always referred to tertiary referral centers for strict surveillance programs and early surgical management of advanced colorectal neoplastic lesions. Noninvasive biomarkers of neoplastic changes are advocated to further improve the management of IBD patients with HCCSs.

CSPG4 overexpression implicates higher risks of recurrence and tumorigenesis after surgical intervention of vocal fold Leukoplakia.

Vocal fold leukoplakia (VFL), a precancerous lesion of the larynx, is characterized by white plaques on the vocal fold mucous membrane. Currently, there are no reliable biomarkers to predict the recurrence and malignant transformation of VFL. Considering chondroitin sulfate proteoglycan 4 (CSPG4) as a biomarker for malignant tumors such as laryngeal squamous cell carcinoma (LSCC), we conducted this cohort study to evaluate the prognostic influence of CSPG4 expression on VFL patients. This study included 44 patients with surgical intervention of VFL. CSPG4 expression in VFL were observed using immunohistochemistry, and the relationship between the prognosis of VFL patients and CSPG4 expression were investigated using Spearman correlation analysis and multiple Cox regression models. During a median follow-up of 89.3 months, recurrence occurred in 19 postsurgical VFL patients, and malignant transformation occurred in 10 patients. The recurrence and malignant transformation group showed significant differences in the H-SCORE of CSPG4 (P = 0.005 and P = 0.045) compared to the the non-recurrence group and the non-malignant transformation group. And the CSPG4 expression level was positive correlation with recurrence and malignant transformation (0.306 or 0.416, spearman correlation confident). Receiver operating characteristic curve analysis indicated that CSPG4 H-SCORE has predictive value for poor prognosis (areas under the curve, 0.742 and 0.710; cut-off points, 82.5 and 177.5, respectively). Multiple Cox regression analysis revealed a statistically significant effect of lesion size (P = 0.014) and CSPG4 H-SCORE (P = 0.005) on recurrence as well as pathological type (P = 0.001) and CSPG4 H-SCORE stratified by 177.5 (P = 0.039). Our survival data indicated that higher CSPG4 expression was associated with a shorter time of recurrence (P = 0.003) and tumorigenesis (P<0.001). CSPG4 overexpression indicates higher risks and shorter time of postoperative VFL recurrence and tumorigenesis. Detection of CSPG4 expression in VFL may be a novel approach to assess the outcome of VFL patients.

Exploring Anti-Aging Effects of Topical Treatments for Actinic Keratosis

Background and Objectives: Actinic keratosis (AK) is a precancerous cutaneous lesion driven by chronic ultraviolet (UV) exposure, often coexisting with features of photoaging, such as wrinkles and pigmentary irregularities. Recent evidence suggests that treatments for AK may also counteract photoaging through shared molecular pathways, including oxidative stress and inflammation. This narrative review explores the dual benefits of AK therapies, highlighting their potential anti-aging and skin-lightening effects, and implications for improving skin appearance alongside lesion clearance. Materials and Methods: The literature was analyzed to assess the efficacy, mechanisms, and cosmetic outcomes of commonly used AK treatments, including topical agents (5-fluorouracil (5-FU), imiquimod, diclofenac, and tirbanibulin), and photodynamic therapy (PDT). Studies highlighting their effects on photoaged skin, collagen remodeling, pigmentation, and patient satisfaction were reviewed. Results: PDT emerged as the most validated treatment, demonstrating improved collagen synthesis, skin texture, and pigmentation. 5-FU showed remodeling of the dermal matrix and increased procollagen levels, but local skin reactions represent a major limitation. Imiquimod enhanced dermal fibroplasia and reduced solar elastosis, while diclofenac provided mild photodamage improvements with minimal adverse effects. Tirbanibulin showed promising aesthetic outcomes, including skin lightening and a reduction in mottled pigmentation, with favorable tolerability. Conclusions: AK therapies offer a dual-purpose strategy, addressing both precancerous lesions and cosmetic concerns associated with photoaging. While PDT remains the gold standard, emerging agents like tirbanibulin ointment exhibit substantial potential. Future research should focus on optimizing treatment protocols and evaluating long-term cosmetic outcomes to enhance patient satisfaction and compliance.

Status and prospect of esophageal cancer screening

Esophageal cancer is one of the global public health problems, which is a serious threat to life and health. Screening is not only an important main measures to reduce the incidence and mortality of esophageal cancer, but also an effective strategy for early prevention and early treatment. There are significant differences in the screening status of esophageal adenocarcinoma and esophageal squamous cell carcinoma cancer between China and abroad. Internationally, there are several guidelines for screening and monitoring of Barrett's esophagus and esophageal adenocarcinoma, but most guidelines do not recommend screening in the general population. The primary screening by sponge ball then endoscopic diagnosis is a new focus. In China, the screening of esophageal cancer and its precancerous lesions is mainly esophageal squamous cell carcinoma, which has been relatively mature and gradually transformed from population screening to opportunistic screening. However, due to the high cost, high technical difficulty and certain invasiveness, it is difficult to popularize and be applied widely; and the canceration rate of precancerous lesions is low, so it is very important to control the cost of screening and scientific follow-up. Moreover, high-risk population should raise their awareness of cancer prevention, actively take primary prevention and the initiative to participate in screening. About medicine institutions, it is urgent to improve the awareness and capacity of early screening. The multi-disciplinary research cooperation, minimally invasive, simple and economical screening methods and multi-omics biomarkers are still explored to detect and concentrate high-risk populations, which will help to optimize screening programs of esophageal cancer and further reduce the incidence and mortality of esophageal cancer.

Understanding cultural perceptions of sexuality in China and their influence on human papillomavirus vaccine hesitancy

IntroductionThe human papillomavirus (HPV) vaccine prevents infections that may result in precancerous lesions, cervical cancers, genital warts, and many other diseases. However, its uptake rate in China is 2.24%, and HPV vaccine hesitancy is widespread. This study aimed to identify whether cultural perceptions of sexuality in China influence HPV vaccine hesitancy and explore the correlation between sexual attitudes, sexual morality, and HPV hesitancy in Chinese.MethodsBetween January and April 2024, we adopted a qualitative approach and conducted in-depth, one-on-one, semi-structured interviews with 15 young female Chinese university students of sexual maturity.ResultsAlthough all college students exhibited vaccine hesitancy, their perceptions of vaccines and reasons for hesitation varied. This study classified hesitancy into three types: individuals hesitant owing to cultural conservatism and stigmatization, individuals with positive intentions but delayed vaccination, and overconfident individuals who disregarded vaccines. The reasons for vaccine hesitancy are linked to China’s conservative culture of sexuality, and Chinese sexual attitudes and morality have complex mechanisms that influence vaccination. Social taboos on sexual topics lead to inadequate sources of information regarding the HPV vaccine. Sexual morality is internalized into an individual’s subconscious, influencing the cognition of the vaccine. Negative associations and stigmatization of the vaccine further discourage vaccination.DiscussionVaccine hesitancy is not solely a medical or political-economic issue but also a deep-seated cultural issue. Culture significantly affects individual health behaviors, and ignoring socio-cultural factors can exacerbate public health problems. Future research should investigate the political-economic and socio-cultural factors to address geographic differences in vaccine hesitancy.

TP53 Wild-type, HPV-independent Anal Growth/(intra)Epithelial Lesion (ANGEL): a Potential Precursor of Anal Squamous Cell Carcinoma.

Human papillomavirus (HPV) underpins approximately 90% of squamous cell carcinomas (SCC) of the anus and perianal region. These tumors usually arise in association with precursor lesions such anal intraepithelial neoplasia/ high-grade squamous intraepithelial lesion (AIN 3/ HSIL), whereas a small subset of HPV-negative cancers may harbor mutations in TP53. Recently, vulvar lesions termed differentiated exophytic vulvar intraepithelial lesion/vulvar acanthosis with altered differentiated (DEVIL/VAAD) have been recognized as HPV-independent, TP53 wild-type precursors for vulvar carcinoma; however, analogous anal lesions have not been described. Cases of diagnostically challenging, TP53 wild-type HPV-negative anal squamous lesions with unusual histologic features including acanthosis and/or verrucous architecture were retrospectively identified. Lesions with koilocytic changes, lack of surface maturation, or significant cytologic atypia were excluded. HPV status was determined by immunohistochemistry for p16 and/or in situ hybridization for low- and high-risk strains, while TP53 status was assessed using immunohistochemistry and molecular studies in a subset of cases, with targeted molecular sequencing performed in three of these. All lesions (5/5) arose in men, ages ranging from 55 to 78 years (median: 65). Verrucous architecture was seen in 2/5 cases, 2/5 were predominantly acanthotic, and 1/5 had both verrucous and acanthotic growth. The lesions were characterized by hyperkeratosis (5/5), hypergranulosis (5/5), and cytoplasmic pallor of upper epithelial layers (2/5). All cases were negative for HPV and had wildtype p53 expression. Three cases with sufficient material for sequencing lacked alterations within the entire coding sequencing of TP53. Invasive SCC was concurrently present in 3/5 cases. In summary, verrucous and acanthotic HPV-independent TP53 wild-type squamous proliferations of the anal and perianal region, referred herein as ANGELs (anal growth/(intra)epithelial lesions), are pre-malignant lesions that have the potential to become invasive, as most of our cases demonstrated synchronous SCC.

Aberrant DNA methylation of EDNRB, MGMT and TIMP3 gene promoters in saliva of head and neck carcinoma patients as a diagnostic tool.

Differential DNA methylation in the promoter region of tumour suppressor genes leads to gene function silencing. In this study, we aimed to evaluate the salivary promoter methylation of EDNRB, MGMT and TIMP3 genes in H&NC patients (n = 100), premalignant lesions patients (n = 25) and healthy controls (n = 50). Blood and saliva samples were collected from all three groups and 20 concomitant tumour tissues were collected from the H&NC patients. Probe-based Methylation-specific PCR (MSP) was performed to assess the relative quantification of methylation. Significant promoter hypermethylation was detected in all three genes between H&NC patients vs. healthy controls and premalignant lesion patients vs. healthy controls. Spearman correlation analysis showed, no significant association between methylation levels and clinicopathological characteristics of HNC patients while tobacco smoking was significantly related to EDNRB methylation in premalignant lesions. The receiver operating curve (ROC) generated for EDNRB, MGMT and TIMP3 genes from saliva samples was able to differentiate between cancer vs. healthy controls and premalignant vs. healthy controls. The combined diagnostic efficiency of the panel was higher than the genes singly. The combined sensitivity of EDNRB and TIMP3 increased to 92%. This indicates that EDNRB and TIMP3 have potential value in clinical practice as effective diagnostic markers for H&NC using saliva samples.

Spectrum of gastric neoplasms in Helicobacter pylori-naïve patients.

Chronic Helicobacter pylori (Hp) infection is the largest etiological factor for gastric cancer, but in recent years the reports of Hp-naïve gastric neoplasms (HpNGNs) have increased as the Hp-infected population in Japan has been declining. The histopathologic spectrum of HpNGNs differs significantly from that of conventional Hp-infected gastric neoplasms. Molecularly, the former harbor considerably fewer genetic and epigenetic abnormalities, reflecting the absence of chronic inflammatory conditions in the gastric mucosa. The majority of HpNGNs fall within several specific histological entities; each arise from particular background mucosa. Most originate from the fundic gland mucosa and have a gastric immunophenotype, as seen in foveolar-type gastric adenoma (FGA), oxyntic gland adenoma (OGA)/gastric adenocarcinoma of fundic gland type (GA-FG), signet-ring cell carcinoma (SRCC), and sporadic fundic gland polyp with dysplasia (FGPD). In contrast, tumors arising from the pyloric or cardiac gland mucosa have a diverse immunophenotype, as seen in intestinal-type gastric dysplasia (IGD) and gastric cardiac carcinoma. FGA, FGPD, SRCC, and IGD are mostly found as small intramucosal lesions. OGA/GA-FG frequently progresses to invasive carcinoma, but only a few have lymph node metastases. Thus, these tumors are regarded as precancerous lesions by Western pathologists, while in Japan they tend to be diagnosed as carcinomas, even in cases of low-grade dysplasia. Gastric cardiac carcinomas, on the other hand, are often found as advanced carcinomas and harbor a high malignant biological potential. A new diagnostic framework for gastric neoplasms is required in the present era of Hp-naïve individuals in Japan.

P0980 Virtual chromoendoscopy is comparable to dye spray chromoendoscopy for IBD surveillance: a single centre retrospective study

Abstract Background Patients with colonic inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer (CRC) and interval surveillance endoscopy is recommended 8 years after diagnosis or symptom onset to identify premalignant lesions (considered to be dysplastic adenomas, sessile serrate lesions [SSL] or large hyperplastic polyps). To enhance detection the current gold-standard technique is dye-spray chromoendoscopy (DCE). Advancements in high-definition electronic imaging have facilitated the development of virtual chromoendoscopy (VCE) and the 2019 European Society of Gastrointestinal Endoscopy (ESGE) guidelines advise that either DCE or VCE can be used. However, there is limited data comparing DCE and VCE. Methods We undertook a retrospective review of the 197 IBD surveillance colonoscopies performed at Frimley Health NHS Foundation Trust in a 6-month period from December 2023 to July 2024 using the accepted techniques of DCE, VCE and white light endoscopy (WLE) with segmental biopsies. DCE (with an indigo carmine mix) and WLE were performed using either Olympus 260, 290 or 1500 colonoscopes, and VCE with Olympus 290 or 1500 colonoscopes using TXI (Texture and Color Enhancement Imaging) optical enhancement in addition to EndoCuff Vision, narrow band imaging (NBI) and/or Endo-Aid CADe computer aided detection where appropriate. Results Of the 197 procedures, 125 (64%) were DCE, 44 (22%) VCE and 28 (14%) WLE with segmental biopsies. 43% (n=85/197) of patients were female and 57% (n=112/197) male. The median age was 52 years (range 21-86) and mean disease duration 18 years (range 2-48). Suspected premalignant lesions were identified in 56% (n=70/125) of cases using DCE; 68% (n=30/44) using VCE; and 29% (8/28) using WLE. Both DCE and VCE were superior to WLE at detecting lesions (p= 0.0016 and p=0.0035 respectively). There was no statistical difference in lesion detection between DCE and VCE (p&amp;gt;0.05). Withdrawal time (median) was shorter in VCE (20 minutes, range 6-67) than DCE (26 minutes, range 10-59), but shortest in WLE (15 minutes, range 7-42). Dysplasia, SSL or hyperplasia were histologically confirmed in 49% (n=34/70) of lesions identified with DCE, 60% (n=18/30) with VCE, and 50% (n=4/8) with WLE. Conclusion VCE is comparable to DCE for lesion detection. Both DCE and VCE are statistically superior to WLE for lesion detection. Withdrawal times are shorter in VCE than DCE without detriment to lesion detection. Optical diagnosis improved with the use of VCE. Our findings support VCE as an acceptable alternative to DCE for IBD surveillance and highlight potential advantages.

Results comparison of cervical cancer early detection using cerviray ® with VIA test

ObjectivesThis study investigates the performance of artificial intelligence (AI) technology, namely Cerviray AI®, compared with Cerviray® expert, aiming to compare its sensitivity, specificity, positive predictive value (PPV), and area under the receiver operating characteristic curve (AUC ROC). The Visual Inspection with Acetic Acid (VIA) test is used as the gold standard.ResultsThe study involved 44 patients from various health centers in West Java Province. Performance of Cerviray AI®, or Cerviray® expert, and lastly VIA tests were compared in their ability to detect pre-cancerous cervical lesions in high-risk women of childbearing age. The current study indicated that Cerviray AI® had a sensitivity of 42.9%, specificity of 100%, PPV of 100%, and ROC AUC values of 71.4%. In comparison, the evaluation of the Cerviray® expert demonstrated a sensitivity of 71.4%, specificity of 97.3%, PPV of 83.3%, and ROC AUC values of 84.4%. In conclusion, the evaluation of Cerviray® expert outperformed Cerviray AI® in ROC AUC values.Trial registrationClinical Trials.gov Identifier NCT06518070 Retrospectively registered.

2024 British Association for Sexual Health and HIV (BASHH) UK national guideline on the management of vulval conditions.

The management of vulval disorders in Genitourinary Medicine (GUM) clinics requires targeted approaches due to the wide range of conditions affecting the vulva. Vulval diseases encompass various aetiologies, including dermatoses, pain syndromes, and pre-malignant conditions, necessitating specialized care often involving multidisciplinary collaboration. This guideline aims to provide evidence-based recommendations for the diagnosis and management of specific vulval conditions that may present in GUM clinics. The focus is on conditions commonly managed by Genitourinary Physicians, either independently or in partnership with other specialists, depending on available local expertise. Additionally, guidance on onward referral is included to ensure optimal patient care. The guideline primarily addresses the management of individuals aged 16 years and older presenting to GUM clinics with non-infective vulval conditions. Recommendations within this guideline are derived from a review of existing literature, clinical expertise, and consensus among specialists. Emphasis is placed on diagnostic tests and treatment regimens tailored to the following conditions: Lichen sclerosus, Lichen planus, Eczema, Lichen simplex, Psoriasis, Vulval high-grade squamous intraepithelial lesions (previously vulval intraepithelial neoplasia), Vulval pain syndromes, and Non-sexually acquired acute genital ulceration (Ulcer of Lipschütz). This guideline offers practical recommendations for the effective management of specific vulval disorders in GUM settings. It is not intended to be a comprehensive review of all vulval diseases but rather a focused resource to assist clinicians in providing high-quality, patient-centred care. Onward referral pathways are also outlined to support collaborative and multidisciplinary management of complex cases.

Predicting the risk of high-grade precancerous cervical lesions based on high-risk HPV typing in Changsha China

BackgroundPersistent infection with high-risk human papillomavirus (HPV) is a significant risk factor for cervical cancer. HPV typing and cytology are conducted in women of appropriate age to assess the risk of cervical lesions and to guide the need for further diagnostic procedures such as colposcopy, cervical biopsy, or treatment. This article explores methods to predict the risks of high-grade precancerous cervical lesions based on high-risk HPV typing.MethodsWe conducted a retrospective analysis of HPV typing data from 158,565 women, including 19,707 who underwent ThinPrep cytologic testing (TCT), 7,539 who had colposcopy examinations, and 4,762 who had biopsies. We evaluated the sensitivity, specificity, and risk parameters of high-grade lesions associated with high-risk HPV types.Results(1) The overall prevalence of HPV infection was 17.89%, with the most prevalent types being HPV52 (4.44%), HPV58 (2.10%), HPV53 (1.96%), HPV81 (1.85%), HPV42 (1.75%), and HPV16 (1.44%). (2) The sensitivity and specificity of detecting high-grade lesions in TCT, colposcopy, and biopsy, based on high-risk HPV typing, demonstrated a strong linear correlation with the infection rate of each type. (3) HPV16 was confirmed to have a higher risk of CIN2 + in biopsies using a self-defined risk parameter. (4) The top five HPV types with the highest PPVs and pathogenicity risks in biopsies were HPV45, HPV16, HPV58, HPV33, and HPV18.ConclusionIn Changsha, China, HPV52, HPV58, and HPV53 were the most prevalent and contributed significantly to high-grade lesions. After adjusting for infection rates, a self-defined risk parameter was proposed as a measure of the intrinsic risks of high-grade lesions associated with high-risk HPV types. Focused monitoring of prevalent high-risk HPV types such as HPV45, HPV16, HPV58, HPV33, and HPV18, which show the highest pathogenicity risks, is recommended in our region.

Potential of Glycyrrhiza in the prevention of colitis-associated colon cancer.

Glycyrrhiza, a legume native to the Mediterranean region, has a long history of ethnomedicinal use in China. Due to its antiviral, antibacterial, anti-inflammatory, antioxidant, antitumor, anti-ulcer, and hepatoprotective properties, Glycyrrhiza is widely utilized in the treatment of gastrointestinal disorders. The specific mechanisms of the main active constituents of glycyrrhiza in the treatment of inflammatory bowel disease, precancerous lesions and colorectal cancer at all stages of the colitis-associated colon cancer "Inflammation-Dysplasia-Cancer" sequence, as well as its pharmacokinetics, toxicology, formulation improvements, and application studies, are reviewed to provide new insights and perspectives on glycyrrhiza as a dietary supplement to treat and prevent colitis-associated colon cancer. Information on Glycyrrhiza was retrieved from electronic databases, including PubMed and Web of Science. Glycyrrhiza is a well-established medicinal plant with significant potential for applications in both the food and pharmaceutical industries. Over 400 active constituents have been identified in Glycyrrhiza, including terpenoids, flavonoids, isoflavones, coumarins, and polyphenols. Numerous studies have demonstrated that Glycyrrhiza and its active compounds can inhibit the "Inflammation-Dysplasia-Cancer" progression of colitis-associated colon cancer by mitigating inflammatory bowel disease, reducing the number of intestinal precancerous lesions, and counteracting colorectal cancer. Furthermore, derivatives and nanocarriers are crucial for the effective treatment of colitis-associated colon cancer using Glycyrrhiza and its active constituents. In conclusion, Glycyrrhiza is a plant with both medicinal and nutritional value, making it a potential food ingredient and dietary supplement for the treatment of colitis-associated colon cancer.

Value of endometrial biopsy in patients with hysteroscopically atrophic endometrium in patients with postmenopausal bleeding.

To determine the rate of precancer and cancer in women presenting with PMB who have a visually atrophic endometrium at hysteroscopy and assess the value of endometrial biopsy in this situation and the adequacy of the samples obtained. Retrospective reviews of all patients with a visually atrophic endometrium at hysteroscopy who had presented with PMB and had an ET > / = 4mm or ET < 4mm with focal changes or irregular features between 2013 and 2024 at University Hospitals of Derby and Burton were included (n = 1096). Patients who had previously had cancer or precancer or had unclear hysteroscopy findings were excluded. The endometrial biopsy histology result was considered the main outcome measure. 188 patients did not have a biopsy performed (17.15%), 660 patients had benign pathology (60.22%), and 239 patients had an inadequate sample result (21.81%). Nine patients had precancerous changes (0.82%). The rate of cancer was 0.00% (n = 0). The NPV of a visually atrophic endometrial cavity at hysteroscopy in detecting precancer or cancer was 99.2%. Patients with an ET < 4mm pre-hysteroscopy and an atrophic endometrial cavity at hysteroscopy were 2.25 times more likely than those whose ET is > 4mm to have an inadequate sample (p < 0.001, 95% CI 1.61-3.16). 10 patients who had an inadequate sample at initial biopsy had a repeat inadequate sample (n = 23, 43.48%). The incidence of precancer/cancer in patients presenting with PMB with a visually atrophic endometrium at hysteroscopy is low. Many patients within this cohort have an inadequate sample at biopsy, and therefore, repeat sampling is of questionable value.

Diagnostic accuracy of human papillomavirus testing on self-collected samples among women referred for colposcopy

To assess the diagnostic accuracy of self-collected urine and vaginal samples for the identification of precancerous cervical lesions in the referral population using high-risk human papillomavirus (hrHPV) assays based on polymerase chain reaction (PCR). It was a prospective study carried out in China from June 2021 to March 2022. The vaginal and urine samples were collected and analyzed by using a newly developed specific hrHPV PCR test, and matched cervical samples were analyzed by using an approved hrHPV DNA test. The primary outcomes were sensitivity for cervical intraepithelial neoplasia 2 or greater (CIN2 +). The secondary outcome was the accuracy of hrHPV findings in urine and vaginal samples compared to cervical samples. A total of 1,701 women were recruited with 113 women excluded. Among 1,588 qualified participants, a total of 203 cases of the CIN2 + group were enrolled in the two centers. The sensitivity and specificity of HPV detection for CIN2 + in urine, vaginal and cervical samples were 86.70% and 36.46%, 90.64% and 30.54%, 93.60% and 26.14%, respectively. The urine sample performed lower sensitivity (p = 0.003) and higher specificity (p < 0.001) than the cervical sample. There was no difference in sensitivity between vaginal and cervical samples (p = 0.146), and the specificity of vaginal samples was higher than that in cervical samples (p < 0.001). The agreement was 78.15% of urine and cervical samples and 85.71% of vaginal and cervical samples. HPV testing on self-collected urine and vaginal samples has acceptable consistency compared with traditional cervical samples. It may be an alternative option for cervical cancer screening. Additional studies are still required to substantiate this issue.

Unmasking the potential: a historical perspective on the evolution of exfoliative cytology in oral cavity neoplasms.

Exfoliative cytology has proven to be a valuable diagnostic tool in the early detection of malignant neoplasms. However, its application in the oral cavity has been met with skepticism and limited investigation due to the perception that clinical examination alone is sufficient for early diagnosis. Nonetheless, recent research efforts have focused on the utility of exfoliative cytology in oral cavity neoplasms, motivated by the high mortality rate associated with oral cancer. This manuscript reviews the historical development of exfoliative cytology in the oral cavity, highlighting key findings and advancements in the field. Early studies demonstrated the presence of neoplastic cells in oral cavity lesions and emphasized the diagnostic potential of cytology. Subsequent research explored different staining methods and observed the differential reaction of oral cavity cells to radiation therapy. The diagnostic accuracy of exfoliative cytology was reported to be as high as 92%, with a significant number of cases diagnosed as carcinomas without any clinical suspicion. The technique also proved valuable in identifying precancerous and dysplastic lesions and obviating the need for unnecessary biopsies. The manuscript delves into the difficulties encountered in sampling techniques and stresses the significance of appropriate specimen collection and handling. Various staining methods, including Papanicolaou and acridine orange, were utilized for cytological analysis. The manuscript emphasizes the extensive use of exfoliative cytology in oral cavity examinations and stresses the importance of recognizing it as a crucial diagnostic tool. Various studies have reported high positivity rates and the detection of clinically unsuspected malignant lesions. The authors recommend extensive use of exfoliative cytology in routine practice and underscore the necessity of proper sampling and evaluation techniques.