• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6459-6463
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• 2013

We investigated the cancer screening rates for five types of cancer (stomach, liver, colorectal, breast, and cervix uteri) using data from the Korean National Cancer Screening Survey (KNCSS), which is a nationwide, annual cross-sectional survey. The eligible study population included cancer-free men 40 years of age and older and women 30 years of age and older. The lifetime screening rate and screening rate with recommendation were calculated. The lifetime screening rates for gastric, liver, colorectal, breast, and cervical cancers were 77.9%, 69.9%, 65.8%, 82.9%, and 77.1%, respectively. The screening rates with recommendation were 70.9%, 21.5%, 44.7%, 70.9%, and 67.9%, respectively. The most common reason for all types of cancer was "no symptoms", followed by "lack of time" and "fear of the examination procedure". Efforts to facilitate participation in liver and colorectal cancer screening among Korean men and women are needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3461-3464
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• 2014

Background: To determine the frequency of dysplastic lesions in the endocervical curettage (ECC) specimens of women with ASC-US and LSIL Pap and to evaluate the possible factors associated with high grade dysplasia in those ECC specimens. Materials and Methods: Two hundred and sixty patients with ASC-US and LSIL cytologic smears who underwent an ECC at the time of colposcopic examination during January 2010 and December 2012 were reviewed. Demographic and clinicopathologic data were collected. Multivariate analysis using binary logistic regression was used to identify factors that might be associated with high grade endocervical dysplasia. Results: The frequency of endocervical dysplasia was 7.7% (20 out of 260 patients). Cervical intraepithelial neoplasia (CIN) 1 and CIN 2-3 lesions in the endocervical canal were observed in 12 and 8 patients, respectively. No microinvasive or invasive cervical cancers were identified. There was no difference in the frequency of high grade endocervical dysplasia between the patients with satisfactory and unsatisfactory colposcopic examinations (1.4% vs 5.1%, respectively, p=0.087). A multivariate logistic regression analysis demonstrated a significant association between high grade CIN on ectocervical biopsy as well as LSIL cytologic smears and high grade dysplasia in endocervical canal (OR=0.046, 95%CI=0.007-0.288; p=0.001 and OR=0.154, 95%CI=0.025-0.942; p=0.043, respectively). Conclusions: The frequency of high grade endocervical dysplasia in women with ASC-US and LSIL cytologic smears was low. Therefore, routine performance of ECC in those women is debatable. High grade ectocervical dysplasia and LSIL cytologic smears may be used as predictors for high grade dysplasia in endocervical canal and ECC in these patients is reasonable.

• Genomics & Informatics
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• v.1 no.2
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• pp.80-86
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• 2003

Human Papillomavirus (HPV) infection is known as the main factor for cervical cancer which is a leading cause of cancer deaths in women worldwide. Because there are more than 100 types in HPV, it is critical to discriminate the HPVs related with cervical cancer from those not related with it. In this paper, the risk type of HPVs using their textual explanation. The important issue in this problem is to distinguish false negatives from false positives. That is, we must find high-risk HPVs as many as possible though we may miss some low-risk HPVs. For this purpose, the AdaCost, a cost-sensitive learner is adopted to consider different costs between training examples. The experimental results on the HPV sequence database show that the consideration of costs gives higher performance. The improvement in F-score is higher than that of the accuracy, which implies that the number of high-risk HPVs found is increased.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1177-1180
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• 2014

Background: Anogenital warts (AGWs) are common results of sexually transmitted infection (STI). Human papillomavirus (HPV) types 6 and 11, which are non-oncogenic types, account for 90% of the clinical manifestations. Although the quadrivalent HPV vaccine has been launched, AGW remains prevalent in some countries and shows association with abnormal cervical cytology. Objectives: To study the prevalence of abnormal cervical cytology (low grade squamous intraepithelial lesions or worse; LSIL+) in immunocompetent Thai women newly presenting with external AGWs. Materials and Methods: Medical charts of all women attending Siriraj STI clinic during 2007-2011 were reviewed. Only women presenting with external AGWs who were not immunocompromised (pregnant, human immunodeficiency virus positive or being on immunosuppressant drugs) and had not been diagnosed with cervical cancer were included into the study. Multivariate analysis was used to determine the association between the characteristics of the patients and those of AGWs and LSIL+. Results: A total of 191 women were eligible, with a mean age of $27.0{\pm}8.9$ years; and a mean body mass index of $20.6{\pm}8.9kg/m^2$. Half of them finished university. The most common type of AGWs was exophytic (80.1%). The posterior fourchette appeared to be the most common affected site of the warts (31.9%), followed by labia minora (26.6%) and mons pubis (19.9%). The median number of lesions was 3 (range 1-20). Around 40% of them had recurrent warts within 6 months after completing the treatment. The prevalence of LSIL+ at the first visit was 16.3% (LSIL 12.6%, ASC-H 1.1%, HSIL 2.6%). After adjusting for age, parity and miscarriage, number of warts ${\geq}5$ was the only factor associated with LSIL+(aOR 2.65, 95%CI 1.11-6.29, p 0.027). Conclusions: LSIL+ is prevalent among immunocompetent Thai women presenting with external AGWs, especially those with multiple lesions.

• Journal of Life Science
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• v.29 no.11
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• pp.1267-1272
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• 2019

The main cause of cervical cancer is the human papillomavirus (HPV), and HPV DNA has been reported in 99.7% of patients with cervical cancer. The worldwide prevalence is highest for the HPV 16 and 18 genotypes, but HPV 52 and 58 have the highest prevalence in Asian countries, including Korea. The purpose of this study was to obtain basic data for the prevention of cervical cancer by analyzing the prevalence of HPV and the genotypes of high risk-human papillomavirus (HR-HPV) infection in women in Busan, Korea. We analyzed 1,995 cases of HPV in women who visited a Busan obstetrics and gynecology hospital from January 2016 to December 2017. The prevalence of HPV among these women was 28.3% (565/1995), and the HR-HPV infection rate was 75.4% (426/565). The HR-HPV genotype with the highest prevalence was HPV-52 (63/565, 11.2%), followed by HPV-58 (56/565, 9.9%), HPV-53 (55/565, 9.7%), and HPV-16 (53/565, 9.4%). The HR-HPV infection rate of young women 18-39 years old was 60.3% (257/426), so this age group should undergo continuous monitoring. The cytological results revealed a high infection rate for HPV-16 in high grade squamous intraepithelial lesions (HSIL) and squamous cell carcinoma (SCC). However, further evaluation of more samples is needed to confirm the HR-HPV genotypes related to the development of cervical epithelial neoplasias.

• Biomedical Science Letters
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• v.22 no.3
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• pp.98-106
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• 2016

Investigation of human papillomavirus (HPV) in archival formalin-fixed paraffin-embedded (FFPE) material is important for understanding cervical carcinogenesis. The objective of the present study was to identify the high risk HPVs (HR-HPVs) using HPV E6/E7 mRNA testing from archival tissues in cervical cancer and the relation to HR-HPVs genotypes in paired cervical exfoliated cells. HPV E6/E7 mRNA testing and DNA chip testing were performed in 79 paired cervical FFPE tissues and exfoliated cells from women with histologically confirmed squamous cell carcinoma and adenocarcinoma. Overall agreement in HR-HPVs detection from FFPE samples and cytology samples were 98.5% in HPV 16, 100% in HPV 18, HPV 31, HPV 33, HPV 58, HPV 66, and HPV 68. Type-specific agreement between FFPE samples and cytology samples was 89.1% in HPV positive, 93.5% in HPV 16 and more than 70% in the other HR-HPVs. In conclusion, HR-HPVs were reliably detected in paired FFPE and cytology samples with some variation in type-specific detection.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5001-5004
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• 2015

The Reid colposcopic index (RCI) helps physicians for interpret the results of colposcopic examination. To compare the accuracy of RCI in colposcopic evaluation between general and oncologic gynecologists, this prospective trial was conducted by invited women over 20 years of age who were scheduled for a colposcopy at Chiang Mai University Hospital between August, 2008 and May, 2014 to participate. Pregnant patients or those having a history of hysterectomy or conization were excluded. During the colposcopy, all patients were simultaneously evaluated by general and oncologic gynecologists utilizing the RCI. Further management with either a biopsy or LEEP in each patient was dependent on the decision of the attending oncologic gynecologist. The accuracy of the RCI in diagnosing HSIL or more was calculated by the comparison with the final histology. Finally, 135 patients were recruited into this study. The sensitivity, specificity, PPV, NPV, and accuracy of RCI in diagnosing HSIL or more in general gynecologists were 45.2%, 80.7%, 41.1%, 83.2% and 72.6% while in the oncologic gynecologists were 51.6%, 85.6%, 51.6%, 85.6% and 77.8%, respectively. The difference in accuracy between evaluator groups was not significant (p-value=0.28). Of 3 patients with invasive cervical cancer, all were undetected by the general gynecologists using RCI while only 1 invasive cervical cancer was missed via RCI by the oncologic gynecologists. We conclude that RCI could be used by general gynecologists in provincial hospitals with major concerns about missing invasive cervical cancer. A short training period regarding colposcopy might help to resolve this problem.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5385-5389
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• 2013

Background: For more than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultanously with radiation. Materials and Methods: Thirty women with untreated invasive squamous cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in the Radiation Oncology Department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty $mg/m^2$ gemcitabine followed by $35mg/m^2$ cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks. One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment. Results: The mean age of patients was $58.1{\pm}11.8$ (29-78) years. After 3 months of treatment, 73.3%had complete and 26.7% demonstrated partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients. Conclusions: According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation using Gemcitabine for advanced cervical cancers.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4353-4356
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• 2016

Purpose: To study the prevalence of CIN2+ diagnosis in women with atypical Papaniculoau (Pap) smears to suggest appropriate management option for Thai health care. Materials and Methods: Data from all patients with liquid based cytology with human papillomavirus (HPV) testing between May 2013 - May 2016 were collected from medical records. Women with atypical cervical Pap smears were recruited. Results for age, HPV testing, HPV 16, 18, 45 and other genotypes tested, colposcopic examination and histopathological assessment were all collected. Atypical smears were defined as atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells cannot be exclude high grade squamous intraepithelial lesion (ASC-H). Results: A total of 2,144 cases were recruited. Twenty six women with ASC-US on cytology had high risk (HR) HPV detection while eight cases with ASC-H had HR-HPV (40.0% VS 72.7%, p=0.005). Among the 26 women with ASC-US cytology and positive HR-HPV, HPV type 16 (n=8, 30.8%), type 18 (n=1, 3.8%), type 45 (n=1, 3.8%) and other HPV types (n=17, 65.4%) were found. Eight women with ASC-H and positive HR-HPV demonstrated type 16 (n=6, 75%) and other HPV types (n=2, 25%). Fifty seven women with ASC-US had normal colposcopy, CIN1 and CIN2+ at percentages of 80.7 (46/57), 14.0 (8/57) and 5.3 (3/57), respectively. In the ASC-H group, 7 out of 10 women had normal colposcopy and three (30%) had CIN2+ results. Conclusions: In women with ASC-US cytology, immediate colposcopy is highly recommended. HPV testing can be performed if colposcopy is not an available option because there was high prevalence (5.3%) of CIN2+ in our findings. ASCCP recommendations for ASC-H that colposcopy should be performed on all ASC-H cases regardless of HPV result are thereby supported by the findings of this investigation.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1037-1047
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• 2016

HOX transcription factors are evolutionarily conserved in many different species and are involved in important cellular processes such as morphogenesis, differentiation, and proliferation. They have also recently been implicated in carcinogenesis, but their precise role in cancer, especially in cervical cancer (CC), remains unclear. In this work, using microarray assays followed by the quantitative polymerase chain reaction (qPCR), we found that the expression of 25 HOX genes was downregulated in CC derived cell lines compared with non-tumorigenic keratinocytes. In particular, the expression of HOXA9 was observed as down-modulated in CC-derived cell lines. The expression of HOXA9 has not been previously reported in CC, or in normal keratinocytes of the cervix. We found that normal CC from women without cervical lesions express HOXA9; in contrast, CC cell lines and samples of biopsies from women with CC showed significantly diminished HOXA9 expression. Furthermore, we found that methylation at the first exon of HOXA9 could play an important role in modulating the expression of this gene. Exogenous restoration of HOXA9 expression in CC cell lines decreased cell proliferation and migration, and induced an epithelial-like phenotype. Interestingly, the silencing of human papilloma virus (HPV) E6 and E7 oncogenes induced expression of HOXA9. In conclusion, controlling HOXA9 expression appears to be a necessary step during CC development. Further studies are needed to delineate the role of HOXA9 during malignant progression and to afford more insights into the relationship between downmodulation of HOXA9 and viral HPV oncoprotein expression during cercical cancer development.