Modern methods for the diagnosis of HPV and cervical intraepithelial neoplasia in the prevention of cervical cancer / UNI-MED Science (PDF)
(Sprache: Englisch)
Cervical cancer is still the most common malignant disease in women in many parts of the third world, associated with a high mortality. No other human cancer is so well understood and offers so many ways of sufficient prevention as cervical cancer. In...
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Cervical cancer is still the most common malignant disease in women in many parts of the third world, associated with a high mortality. No other human cancer is so well understood and offers so many ways of sufficient prevention as cervical cancer. In contrast to most other malignant diseases, the genesis of cervical cancer is essentially linked to just one major cause - infection with human papillomavirus (HPV). Knowledge about the genesis of cervical cancer exploded during the last two decades and resulted in a new concept of primary prevention of cervical cancer using HPV vaccination and to improve current secondary prevention programmes with HPV testing. As usual, new concepts raise new ques-tions.
This book summarizes the current knowledge about screening for cervical cancer and the state of the management of atypical screening results in greater details. The authors are well known experts in their fields, who were directly involved in basic and clinical research on all aspects around HPV and cervical cancer prevention for many years. Their contributions about the role of HPV in the genesis of cervical cancer, new chances in primary and secondary prevention and management of atypical screening results should help physicians and other health professionals with an interest in cervical cancer prevention to understand the current level of evidence and to transform it into better clinical practice.
This book summarizes the current knowledge about screening for cervical cancer and the state of the management of atypical screening results in greater details. The authors are well known experts in their fields, who were directly involved in basic and clinical research on all aspects around HPV and cervical cancer prevention for many years. Their contributions about the role of HPV in the genesis of cervical cancer, new chances in primary and secondary prevention and management of atypical screening results should help physicians and other health professionals with an interest in cervical cancer prevention to understand the current level of evidence and to transform it into better clinical practice.
Inhaltsverzeichnis zu „Modern methods for the diagnosis of HPV and cervical intraepithelial neoplasia in the prevention of cervical cancer / UNI-MED Science (PDF)“
1. Human papillomavirus and cervical cancer 13 1.1. How does HPV cause cervical cancer? (M. von Knebel Döberitz, L. Gissmann) 13 1.1.1. Background 13 1.1.2. The papillomavirus life cycle 13 1.1.3. HPV-uptake, replication and arguments for a potential latent infection 13 1.1.4. The concept of transforming HPV infections 17 1.1.5. Epigenetic modification of cellular and viral genomes as fundamental process during squamous cell differentiation and viral replication 18 1.2. The epidemiology of human papillomavirus infections and cervical cancer (F.X. Bosch) 23 1.2.1. Abstract 23 1.2.2. The global burden and natural history of HPV infection 23 1.2.3. Epidemiological evidence for the causal link between HPV and cervical cancer 24 1.2.3.1. HPV DNA prevalence and type distribution in cervical cancer 24 1.2.3.2. HPV prevalence and type distribution in women with high-grade cervical lesions 25 1.2.3.3. Case control studies 25 1.2.3.4. Cohort studies 27 1.2.3.5. Cofactors for cervical cancer: Hormones, cigarette smoking, viral coinfections and behaviour 27 1.2.3.6. The role of HPV in genital cancers other than cervical 28 1.2.3.7. Public health implications 28 2. Screening strategies to prevent cervical cancer 31 2.1. Basics of screening for clinicians (K.U. Petry) 31 2.1.1. Introduction 31 2.1.2. Defining primary prevention, primary screening and triage 31 2.1.3. Sensitivity, specificity, PPV, NPV and their dependence on the population examined 32 2.1.4. Conclusions for clinicians for primary screening and triage 33 2.2. Thinlayer cytology and computerassistance in cytology (H. Ikenberg) 33 2.3. HPV testing in cervical cancer screening (CJLM Meijer, D.C. Rijkaart, J. Berkhof, PJF Snijders, M. Arbyn) 41 2.3.1. Which test 44 2.3.2. Quality assessment 45 2.3.3. Triage of hrHPV-positive women 45 2.3.4. At what age do we need to start hrHPV testing? 45 2.3.5. Guidelines for cervical screening 46 2.3.6. Conclusions 46 2.3.7. Abstract 46 2.4. Biomarkers in cervical cancer
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screening: Basic principles and clinical evaluation (M. von Knebel-Döberitz, C. Bergeron) 49 2.4.1. Introduction 49 2.4.2. Basic pathogenesis of HPV infections and its impact for biomarker identification 50 2.4.3. Biomarkers that help to define the individual phases of HPV infections 52 2.4.4. Biomarkers for HPV infections 53 2.4.5. Biomarkers for permissive HPV infections 53 2.4.6. Biomarkers for transforming HPV infections (p16INK4a and the CINtec concept) 53 2.4.7. Markers for aberrant S-phase induction (ProEx C) 56 2.4.8. E6/E7 mRNA tests 57 2.4.9. Conclusions 57 3. From screening results to diagnosis 62 3.1. Triage of borderline/low-grade Pap cytology (S. Nazeer, M.I. Shafi) 62 3.1.1. Introduction 62 3.1.2. Minor cervical cytological abnormality 62 3.1.3. ALTS study - ASCUS/LSIL triage study for cervical cancer 63 3.1.4. TOMBOLA study - Trial of management of borderline and other low-grade abnormal smears 63 3.1.5. Meta-analyses and overviews 64 3.1.6. Other technologies 64 3.1.7. Summary 65 3.2. Triaging of HPV-positive women (K.U. Petry) 66 3.2.1. The dilemma of HPV-positive results - only few cases will hide high-grade disease 66 3.2.2. Immediate colposcopy 67 3.2.3. Triage of HPV+ with cytology: Results from RCTs and other studies 68 3.2.4. Triage of HPV+ with repeat HPV testing 69 3.2.5. Triage of HPV+ using genotyping 69 3.2.6. Triage of HPV+ using HPV mRNA E6/E7 70 3.2.7. Triage of HPV+ with p16 70 3.2.8. Triage of HPV+ with p16-Ki67 dual staining 71 3.2.9. Triage of HPV+ with methylation markers 72 3.2.10. Summary 72 3.3. Colposcopy (K.U. Petry, M.I. Shafi) 76 3.3.1. Introduction 76 3.3.2. Technique 76 3.3.3. Atypical transformation zone 76 3.3.4. Grading Systems 77 3.3.5. New technology 78 3.3.6. Randomized controlled studies and meta-analyses of colposcopy as a diagnostic technique 79 3.3.7. Adverse effects of colposcopy 80 3.3.8. Referral for colposcopy threshold 80 3.3.9. Future role of colposcopy 80 3.4. Histopathology (T. Junkers, T. Löning) 81 3.4.1. Summary 81 3.4.2. Introduction 82 3.4.3. Squamous intraepithelial neoplasia (cervical intraepithelial neoplasia CIN) 82 3.4.3.1. Squamous intraepithelial lesion, low grade 82 3.4.3.2. Squamous intraepithelial lesion, high grade 83 3.4.3.3. SIL - differential diagnosis 84 3.4.3.4. Biomarkers 84 3.4.4. Glandular intraepithelial neoplasia 84 3.4.4.1. ACIS - differential diagnosis 85 3.4.5. Microinvasive (early invasive) cervical carcinoma 86 3.4.6. Invasive squamous cell carcinoma 87 3.4.7. Invasive adenocarcinoma 87 4. Will vaccination be the ultimate solution to eradicate cervical cancer? (F.X. Bosch) 89 4.1. Abstract 89 4.2. Eradication of an infectious disease 89 4.3. Eradication of cervical cancer 89 4.4. Social requirements for eradication 90 4.5. Primary and secondary prevention in developed countries: current options 90 4.5.1. HPV vaccines 90 4.5.2. Pap smears and HPV screening 91 4.6. Primary and secondary prevention in developing countries 91 4.6.1. Technology developments: second generation vaccines 91 4.7. Public Health considerations and conclusions 92 Index 95
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Bibliographische Angaben
- Autor: K. Ulrich Petry
- 2011, 1. Auflage, 96 Seiten, Englisch
- Verlag: Uni-Med Verlag Ag
- ISBN-10: 3837452662
- ISBN-13: 9783837452662
- Erscheinungsdatum: 15.06.2011
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