RESUMEN
BACKGROUND: The therapeutic strategy for stage IB3, IIA2, and IIB cervical cancer is still controversial. The modalities are chemoradiation, radical hysterectomy surgery, or administration of neoadjuvant chemotherapy followed by radical hysterectomy. Response to chemotherapy is determined by tumor vascularization or angiogenesis, proliferative activity, and genetic instability of cervical cancer. The marker of tumor cell proliferation is the Ki-67 protein. In cervical cancer, the p53 gene is suppressed by human papillomavirus (HPV). The HPV E6 protein promotes the degradation of p53 thereby inhibiting stabilization and activation of p53. This study aimed to prove that high expression of VEGF, Ki-67, and p53 are risk factors for a poor response to neoadjuvant chemotherapy. METHODS: This was a case-control study that was conducted at the Department of Obstetrics and Gynecology in one tertiary hospital in Denpasar from October 2021 to April 2022. There were 56 samples included in this study, which were divided into two equal groups, namely good response and poor response to neoadjuvant chemotherapy. Data were analyzed using the software SPSS-24 including the Kolmogorov-Smirnov normality test, Chi-square, and multiple regression logistics. Data were presented in tables and described narratively. RESULTS: It was found that the risk of a poor response to chemotherapy on the expression of VEGF VEGF, Ki-67, and p53 were 11.5, 15.0, and 8.33 times, respectively. We obtained a formula for calculating chemotherapy response, y = -7.3+ 1.6 VEGF + 1.6 Ki-67 + 1.8 p53. High VEGF, Ki-67, and p53 expressions were scored 1, and low expressions were scored 2. The limit value used is 0.05. The result y < 0.05 means the risk of poor response to chemotherapy and the value of y > 0.05 means good response. CONCLUSION: This formulation can be used as a parameter to assess the risk of poor response to neoadjuvant chemotherapy in stage IB3, IIA2, and IIB cervical cancer which can be applied in clinical practice in the treatment of cervical cancer.
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Protocolos de Quimioterapia Combinada Antineoplásica , Carboplatino , Antígeno Ki-67 , Terapia Neoadyuvante , Paclitaxel , Proteína p53 Supresora de Tumor , Neoplasias del Cuello Uterino , Factor A de Crecimiento Endotelial Vascular , Humanos , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/tratamiento farmacológico , Neoplasias del Cuello Uterino/metabolismo , Femenino , Terapia Neoadyuvante/métodos , Factor A de Crecimiento Endotelial Vascular/metabolismo , Antígeno Ki-67/metabolismo , Estudios de Casos y Controles , Proteína p53 Supresora de Tumor/metabolismo , Paclitaxel/administración & dosificación , Paclitaxel/uso terapéutico , Carboplatino/administración & dosificación , Persona de Mediana Edad , Factores de Riesgo , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Adulto , Pronóstico , Biomarcadores de Tumor/metabolismo , Estudios de Seguimiento , Estadificación de NeoplasiasRESUMEN
BACKGROUND: Immunotherapy is gaining attention and it is being included as one of the treatment strategies for cancer patients. However, the molecular mechanisms of immune-related genes and their affinity for cervical cancer progression remain unclear. In this study, we have developed an immune-related competing endogenous RNA [ceRNA] network and assessed the tumour infiltrating immune cells towards the prognosis of cervical cancer. METHODS: Differential RNA expression pattern between stages I and II-IV of cervical cancer patients from The Cancer Genome Atlas [TCGA] was analyzed. Immune-related ceRNA network based on the immune gene signatures were retrieved and their targets were predicted using miRwalk 3.0. CIBERSORT was employed to identify the immune cell types based on their respective transcripts. The prognostic significance of RNAs in the ceRNA network and immune cell subsets was analyzed. RESULTS: Significant differences in 22 long non-coding RNAs [lncRNAs], 15 microRNAs [miRNAs], and 252 messenger RNAs [mRNAs] between stages I and II-IV of cervical cancer were observed. Further, we shortlisted the 49 immune-related mRNAs based on immune gene signature and predicted their target miRNAs and lncRNAs. A potential ceRNA network of 4 lncRNAs, 10 miRNAs, and 11 mRNAs had a strong correlation for prognosis. Out of 11 protein-coding immune mRNAs, IRF4 and AZGP1 had high degrees of interaction. In addition, the evaluation of immune cell subsets showed increased infiltration of M1 macrophages had better survival outcome. CONCLUSIONS: We have identified an immune-related ceRNA network based on differentially expressed transcripts between stages I and II-IV which may help predict the prognosis of cervical cancer.
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MicroARNs , ARN Largo no Codificante , Neoplasias del Cuello Uterino , Femenino , Humanos , ARN Largo no Codificante/genética , ARN Largo no Codificante/metabolismo , Neoplasias del Cuello Uterino/genética , Redes Reguladoras de Genes , Pronóstico , MicroARNs/genética , MicroARNs/metabolismo , ARN Mensajero/genética , ARN Mensajero/metabolismo , Regulación Neoplásica de la Expresión Génica , Biomarcadores de Tumor/genéticaRESUMEN
BACKGROUND: The human papillomavirus (HPV) is an important public health problem that can cause cervical cancer. HPVs were classified into high-risk (HR-HPV) and low-risk (LR-HPV) types. In this study, we aimed to determine the prevalence and genotype distribution of HR-HPV infection in Samsun province in Turkey. METHODS: Cervical smear samples taken from 5406 women over a 23-month period were evaluated for the presence of HPV infection. The detection of HPV genotypes was performed using RT-PCR technology. HPV detection and genotyping were performed using RT-PCR method. HR- HPV types are divided into 3 groups as type 16, type 18 and other types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, with or without type 16 and 18). The results were evaluated statistically. RESULTS: The mean age of HR-HPV positive patients was 39.56 years (20-68 years). The prevalance of HR-HPV types did not differ between different age groups (pË0.05). Overall, 9.17% of women (496/5406 samples) were found to be positive at least one type of HR-HPV. HPV type 16 was detected in 28.62%, type 18 in 9.67%, and other types in 78.83%. The most common HR-HPV type was other types (pË0.001). Type 16 was most common than type 18 (pË0.001). The patients were evaluated by dividing them into 6 age groups. Type 16 positivity was higher in 30-39 ages while type18 and other types positivity were higher in the 40-49 age group. When the 23-month period of HPV test was evaluated according to months and seasons, the highest prevalance was seen in June 2021 and Summer 2021. CONCLUSION: To our knowledge, this is the first large-scale study of HR-HPV prevalence and genotype distribution among women in Samsun Province of Turkey. The other types containing one or more types made up the majority of the studied population.
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Alphapapillomavirus , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Adulto , Alphapapillomavirus/genética , ADN Viral/análisis , ADN Viral/genética , Femenino , Genotipo , Humanos , Papillomaviridae/genética , Prevalencia , Turquía/epidemiología , Neoplasias del Cuello Uterino/epidemiologíaRESUMEN
OBJECTIVE: This study aims to compare the clinical application value of high-flux dialysis with low-flux dialysis in patients without significantly improved renal function after cervical cancer and obstructive renal failure catheterisation. METHODS: This prospective randomised study was conducted from January 2018 to December 2019. Eighty cervical cancer patients with obstructive renal failure who showed no significant renal function improvement after catheterisation were randomised into two groups (n = 40 in each group) in the Second People's Hospital of Yibin City. High-flux and low-flux dialysis were employed in the experimental group and the control group, respectively. Treatments in both groups were provided every other day, with the whole course lasting one week. Data were recorded before and after dialysis included inflammatory factors such as IL-6, CRP and TNF-a, large and moderate molecular toxins (e.g., ß2 micro-globulin, parathyrin (PTH) and cysteine protease inhibitor). Renal function changes during the dialysis were also recorded. Afterwards, the two groups were compared regarding the overall efficacy. RESULTS: Both the experimental group and the control group experienced a significant decrease in IL-6, CRP, TNF-a, ß2 micro-globulin, PTH and cysteine protease inhibitor, with the decrease in the experimental group being more evident (p < 0.05). After dialysis was completed, the experimental group restored renal function indicators such as Cre, CysC and serum K+ levels more quickly than the control group (p < 0.05). The effective rate was 100% for the experimental group and 87.5% for the control group. The intragroup difference in the efficacy.was significant. CONCLUSIONS: High-flux dialysis appears to be more beneficial for cervical cancer patients with obstructive renal failure, showing no significant improvement in renal function after catheterisation. It restored renal function more quickly, had more radical draining of inflammatory factors and large and moderate molecular toxins, and had a higher overall effective rate.
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OBJECTIVE: The rising prevalence of cancer of the cervix especially in developing countries gives cause for concern. Fortunately, it can be prevented especially when the women at risk possess correct knowledge, have the right belief and access to screening and prevention services. Previous studies have reported poor knowledge and screening practices among women in developing countries raising the fear of continued spread. The aim of the study was to establish the cervical cancer knowledge, belief and prevention/screening practices among women in Taraba, North-East Nigeria. METHODS: The study adopted a cross sectional survey design. A self-designed structured and validated questionnaire with a reliability index of .82 was employed to elicit information from 978 women of child bearing age. Data collected were analysed using percentage, mean, Chi-Square and ANOVA statistics. RESULT: The findings of the study revealed that the women of Taraba had appropriate knowledge about the nature of cervical cancer (73. 2%) signs and symptoms of cervical cancer (76.5%) risk factors of cervical cancer (88.0%), and prevention of cervical cancer (90.3%). The women did not have the right beliefs about the concept of cervical cancer and its preventive measures. They believed that the screening procedure is painful; they were too young to contract the disease and risk stigmatization if they went for screening. Only 45.2% of the women regularly engaged in screening and other prevention practices. Location of residence, and religion significantly determined knowledge and screening/prevention practices (P<0.05) while marital status and age (P<0.05) significantly affected the respondents' beliefs about cervical cancer and prevention practices. Location of residence, and religion significantly determined knowledge and screening/prevention practices (P<0.05) while marital status and age (P<0.05) significantly affected the respondents' beliefs about cervical cancer and prevention practices. CONCLUSION: It was concluded that knowledge about cervical cancer did not translate to right belief and good practice, and that belief and practice were affected by demographic variables of location of residence, religion, marital status and age.