Journal of Lower Genital Tract Disease最新文献

{"title":"ASCCP President's Message.","authors":"Michelle J Khan","doi":"10.1097/LGT.0000000000000898","DOIUrl":"10.1097/LGT.0000000000000898","url":null,"abstract":"","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"205-206"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Significance of Extended HPV Genotyping for Detecting Endocervical Glandular Neoplasia for Atypical Glandular Cells.","authors":"Fangfang Zhong, Megan L Zilla, Yihua Sun, Xianxu Zeng, Hao Zhang, Jianan Xiao, Xiang Tao, Chengquan Zhao","doi":"10.1097/LGT.0000000000000886","DOIUrl":"10.1097/LGT.0000000000000886","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the risk of cervical glandular neoplasia with extended high-risk human papillomavirus (hrHPV) genotyping, in patients with atypical glandular cells (AGC) cytology.</p><p><strong>Methods: </strong>Cervical AGC cases with concurrent extended HPV genotyping between October 2017 and October 2023 were retrieved from the archives of Department of Pathology, Obstetrics, and Gynecology Hospital of Fudan University (OGHFU).</p><p><strong>Results: </strong>A total of 497 AGC cases with extended hrHPV genotyping showed an hrHPV-positive rate of 32.0%. The top 4 hrHPV types were HPV18, 16, 52, and 59. A total of 304 cases had histological follow-up. A total of 72 cases (23.7%) had cervical adenocarcinoma in situ/cervical intraepithelial neoplasia3 or worse (AIS/CIN3+) lesions with 43 endocervical carcinoma (EC-ADC), 28 AIS, and 1 CIN3. Cervical AIS/CIN3+ lesions were detected in 50.5% (55/109) of the hrHPV-positive group. Women with HPV18/16/45 positivity had 77.6% cumulative risk of cervical AIS/CIN3 + lesions (52/67), accounting for 94.6% (52/55) of the total hrHPV-associated cervical AIS/CIN3+ lesions. For all 15 other hrHPV types, the overall risk of AIS/CIN3+ was 7.1% (3/42 cases). The sensitivity, specificity, PPV, and NPV of the composite HPV18/16/45 group for detecting endocervical glandular neoplasia was 71.8%, 93.1%, 76.1%, and 91.6%, respectively. Endocervical carcinoma was found in 17 of 195 (8.7%) women with negative hrHPV testing, accounting for 39.5% EC-ADC (17/43) cases.</p><p><strong>Conclusions: </strong>Atypical glandular cells was rarely related to CIN3. Atypical glandular cells was strongly related to AIS and EC-ADC. Women aged 30-49 years had highest risk for AIS/CIN3+ lesions. Although HPV test can be helpful, there were still some cases of HPV-negative endocervical adenocarcinomas. Extended HPV genotyping in AGC cases identified certain HPV types associated with a higher risk of cervical glandular lesions, potentially assisting with risk stratification.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"223-228"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Rapid Antigen Tests for Trichomoniasis: A Meta-Analysis.","authors":"Ke-Yu Hsiao, Hsiu-Ling Lin, Hui-Mei Chen, Cheng-Chieh Chen","doi":"10.1097/LGT.0000000000000873","DOIUrl":"10.1097/LGT.0000000000000873","url":null,"abstract":"<p><strong>Objective: </strong>Trichomoniasis is a globally prevalent sexually transmitted infection caused by the protozoan Trichomonas vaginalis . Polymerase chain reaction (PCR) is the gold standard for diagnosing trichomoniasis, but it is expensive. Antigen tests are immunochromatographic immunoassays that detect T. vaginalis membrane proteins. Despite being user-friendly and rapid, the diagnostic accuracy of antigen tests remains uncertain. Therefore, this meta-analysis aimed to evaluate the diagnostic accuracy of antigen tests for T. vaginalis infections.</p><p><strong>Methods: </strong>The authors mined the PubMed, Embase, and Cochrane Library databases for studies evaluating the diagnostic accuracy of antigen tests for T. vaginalis . They included studies that provided diagnostic test accuracy data in order to conduct a meta-analysis. They evaluated antigen tests based on immunochromatography and lateral flow devices. The meta-analysis was conducted by using the hierarchical summary receiver operating characteristic model.</p><p><strong>Results: </strong>Eleven studies with 5,884 samples were included. The meta-analysis yielded a pooled sensitivity of 87.0% and a pooled specificity of 98.3%. A subgroup analysis employing PCR as the reference standard yielded a sensitivity of 58.5%, whereas another subgroup analysis using culture returned a sensitivity of 95.9%. The subgroup analysis of 6 studies comprising 2,328 specimens from symptomatic individuals yielded a pooled sensitivity of 85% and a specificity of 99.9%.</p><p><strong>Conclusions: </strong>The antigen tests exhibited high sensitivity and specificity. Additionally, subgroup analyses revealed that antigen tests demonstrated greater sensitivity in diagnosing symptomatic patients compared to asymptomatic individuals. While less sensitive than PCR, antigen testing remains a promising avenue for detecting T. vaginalis infections.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"273-279"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triage Value of Cervical Exfoliated Cell DNA Ploidy Analysis in Cervical High-Risk Human Papillomavirus-Positive Women: Erratum.","authors":"Boliang Chu, Jie Dong, Yingying Chen, Xiaofang Ru, Wenwen Zhang, Yun Chen, Xiaoxing Zhang, Xiaodong Cheng","doi":"10.1097/LGT.0000000000000889","DOIUrl":"10.1097/LGT.0000000000000889","url":null,"abstract":"","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"296"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Government-Financed Cervical Cancer Screening in Hunan, China, and Optimization of Triage Strategies.","authors":"Zexi Liao, Kehan Zou, Ming Lei, Yinglan Wu, Wenqing Yang, Yu Zhang","doi":"10.1097/LGT.0000000000000875","DOIUrl":"10.1097/LGT.0000000000000875","url":null,"abstract":"<p><strong>Objectives: </strong>Cervical cancer is a preventable and manageable public health concern. This study aimed to evaluate the performance of a government-financed cervical cancer screening program and to discuss optimal primary screening approach and triage strategies for large-scale population screening.</p><p><strong>Methods: </strong>This population-based study was conducted from 2015 to 2020 and included 6,373,279 eligible women. The performance of the cervical cancer screening program in Hunan Province was evaluated by comparing cancer incidence and mortality rates. The screening powers of primary human papillomavirus (HPV) testing and cytology were compared by calculating positive outcomes and cervical intraepithelial neoplasia 2 or worse (CIN2+) detection rates. Triage strategies for individuals positive for HPV-16/18 after primary HPV testing were discussed by comparing the CIN2+ detection rates and associated costs.</p><p><strong>Results: </strong>The cervical cancer screening program has contributed to lower cancer mortality rates in Hunan Province. The HPV testing showed a higher CIN2+ detection rate than cytology as the primary screening approach (0.604% vs. 0.324%). For individuals positive for HPV-16/18, reflex cytology demonstrated a higher CIN2+ detection rate than direct colposcopy (51.11% vs 41.25%), although it was more expensive. For individuals with high-risk HPV types other than HPV-16/18, direct colposcopy exhibited a similar CIN2+ detection power as reflex cytology, but cost less.</p><p><strong>Conclusions: </strong>The cervical cancer screening program should be expanded because the benefits outweigh the costs. Statistical data indicate that HPV testing is a cost-effective preliminary screening approach for large-scale population screening.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"207-212"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Risk of Developing Cervical Cancer in the Elderly: Who Benefits From Screening After the Age of 60?","authors":"Renée M F Ebisch, Celine Buijssen, Nicole C M Visser, Albert G Siebers, Ruud L M Bekkers","doi":"10.1097/LGT.0000000000000893","DOIUrl":"10.1097/LGT.0000000000000893","url":null,"abstract":"<p><strong>Objectives: </strong>Population-based cervical cancer screening in the Netherlands ends at age 60. This retrospective cohort study aims to identify a subgroup of people over 60 years who are at increased cervical cancer risk, and may benefit from extended screening.</p><p><strong>Methods: </strong>People with a cervix, aged 59-61 with an abnormal exit smear (index smear), conducted as part of the screening program between 2000 and 2004, were identified from the Dutch nationwide pathology databank. A 1:3 matching was obtained with people without an abnormal screening smear at the same age. Incidence rate ratios (IRR) were calculated for the risk of developing cervical cancer or cervical intraepithelial neoplasia (CIN) later in life. Up to 22 years of follow-up was obtained.</p><p><strong>Results: </strong>A total of 10,368 people were identified. The IRR for CIN and cervical cancer was increased for people with an abnormal index smear. This risk was highest for people with a high-grade index smear, compared with a normal index smear; IRR of high-grade CIN of 104.05 (95% CI = 38.18-353.18) and IRR for cervical cancer of 18.58 (95% CI = 5.31-61.07). The majority (82%) of people with an abnormal index test showed normal cytology or histology preceding their CIN or cervical cancer.</p><p><strong>Conclusions: </strong>People with a cervix with abnormal cytology in their exit screening smear 59-61 years showed a 19 times increased lifelong risk of cervical cancer and more than 100 times increased risk for CIN. Because this increased risk was not limited to a specific timeframe, prolonged screening or adjusted diagnostic follow-up for this specific group should be considered.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"229-234"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awards Presented as Part of the ASCCP 2025 Scientific Meeting on Anogenital & HPV-Related Diseases.","authors":"","doi":"10.1097/LGT.0000000000000897","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000897","url":null,"abstract":"","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":"29 3","pages":"295"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotherapy and Psychotherapeutic Techniques for the Treatment of Vulvodynia: A Systematic Review and Meta-Analysis.","authors":"Janice F Queiroz, Ayane C A Sarmento, Antonio C Q Aquino, Amaxsell Thiago Barros de Souza, Kleyton Santos de Medeiros, Megan L Falsetta, Ana Katherine Gonçalves","doi":"10.1097/LGT.0000000000000881","DOIUrl":"10.1097/LGT.0000000000000881","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness of psychotherapy and psychotherapeutic techniques for reduction of vulvar pain and the improvement of sexual function and psychological adjustment in vulvodynia.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, PsycInfo, and Clinical Trial Databases were searched on July 19, 2024. The authors included randomized controlled trials comparing psychotherapy interventions and psychotherapeutic techniques for vulvodynia. The risk of bias was assessed using the Cochrane Risk of Bias (RoB 2.0) tool. RevMan 5.4 was used for data synthesis. The Grading of Recommendations Assessment Development (GRADE) and Evaluation method was used to assess the strength of the evidence.</p><p><strong>Results: </strong>A total of 1,884 articles were retrieved. Eight studies met the eligibility criteria and were included in the systematic review, comprising 689 participants. Two studies were included in the meta-analysis, these with 143 participants. When comparing the Acceptance and Commitment Therapy (ACT) with the control group, the mean difference (MD) in the pooled analysis for the Chronic Pain Acceptance Questionnaire did not differ significantly between ACT therapy and other therapies for posttreatment assessment (MD = 0.77; 95% CI = 3.45-4.99). Only 1 study was at high risk of bias due to a lack of clarity about the outcome measurement process. The GRADE rating for the certainty of the evidence for vulvar pain acceptance using ACT was considered low.</p><p><strong>Conclusions: </strong>Psychotherapy significantly improves vulvar pain, psychological adjustment, and sexual function in women with vulvodynia. Additionally, this meta-analysis showed that ACT and other psychotherapeutic interventions improve psychological adjustment through pain acceptance. However, more rigorous studies are needed to improve the quality of evidence and inform clinical practice.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"280-287"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Incidence of Vaginal Intraepithelial Neoplasia 2+ in Patients With Previous Hysterectomy Cervival Intraepithelial Neoplasia 3+ Between 2005-2015: A Population-Based Study.","authors":"Sabrina Piedimonte, Bronwen R McCurdy, Joan Murphy, Dustin Costescu, Carolyn Barg, Yingzi Li, Tina Karapetyan, Julia Gao, Rachel Kupets","doi":"10.1097/LGT.0000000000000894","DOIUrl":"10.1097/LGT.0000000000000894","url":null,"abstract":"<p><strong>Objectives: </strong>In light of the rarity of vaginal cancer, the role of vaginal vault testing following hysterectomy for preinvasive or early cervical cancers is unclear. The objective was to determine the subsequent risk of VaIN2/3, and invasive vaginal cancer following hysterectomy, and to potentially identify individuals at higher risk who may benefit from vaginal vault testing.</p><p><strong>Methods: </strong>The authors performed a population-based retrospective study using administrative databases to identify the study population. They identified patients who between 2005-2015 underwent hysterectomy after cervival intraepithelial neoplasia 3+ (CIN3+)/adenocarcinoma in situ (AIS) and calculated the rate of VAIN2 and invasive vaginal cancer. Exclusion criteria are as follows: <21 years and CIN3+ diagnosis prior to 2005. Patients were followed until 2021.</p><p><strong>Results: </strong>During the study period, 6,230 patients underwent hysterectomy for a diagnosis of CIN3+/AIS. The subsequent rates of VaIN2/3, in situ, and invasive cancer were 1.9% (119/6,230) and 0.3 (18/6,230), respectively. Of these, most (84.7%) were made within 5 years of hysterectomy and remained stable over time (2.0% in 2005-2009, 2.4% in 2010-2015). However, only 54% of patients had vault cytology after hysterectomy; among these, 8.2% were abnormal of which 22.8% were diagnosed with VAIN2+. In addition, the risk of VaIN2+ was 5.8% when there was residual CIN3+ versus 2.1% when absent.</p><p><strong>Conclusions: </strong>Individuals with evidence of CIN3+/AIS at time of hysterectomy are at elevated risk of developing VAIN 2+, with the highest risk occurring within 5 years from surgery. Vault cytology within 1 year of surgery will identify most cases of VAIN2+, but further data monitoring and integration of HPV testing will be required to determine this screening strategy.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":"29 3","pages":"239-242"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-Label Use of Imiquimod for Lower Female Genital Tract Diseases: A Systematic Review.","authors":"Flavia Silvestri, Giulio Tosti, Francesca Pepe, Sara Gandini, Mario Preti","doi":"10.1097/LGT.0000000000000888","DOIUrl":"10.1097/LGT.0000000000000888","url":null,"abstract":"<p><strong>Objectives: </strong>Imiquimod (IMQ) is an immunomodulatory topical drug with antiviral and antitumoral activity. Given its effectiveness and safety, IMQ is broadly off-label used for many vulvovaginal conditions as monotherapy and in association with other therapeutic approaches. However, standardized dose regimens and the total duration of therapy are still debated. This review aimed to summarize the current evidence on off-label uses of IMQ in different vulvovaginal conditions and compare its effectiveness to other gold standard treatments.</p><p><strong>Methods: </strong>The literature review used PubMed/MEDLINE and ClinicalTrial.gov as primary sources, including articles from January 2000 to June 2024.</p><p><strong>Results: </strong>Overall, 105 articles were included, of which 26 articles on vulvar Paget disease, 36 articles on vulvar intraepithelial neoplasia, 20 articles on vaginal intraepithelial neoplasia, 6 articles on vulvovaginal melanoma, and 17 articles on other conditions (molluscum contagiosum, herpes simplex type II infection, plasma cell vulvitis, and candidiasis). Most treatments included IMQ as monotherapy, or in combination and/or in alternative to other approaches, such as surgery, laser, human papillomavirus vaccination, systemic therapies (antiviral drugs, steroids), local therapies (1% cidofovir, 5% 5-fluorouracil, photodynamic therapy), and observation. The most frequent dose regimen was 3 times/week for 12-16 weeks. Outcomes widely varied among different conditions.</p><p><strong>Conclusion: </strong>Off-label topical IMQ represents a noninvasive and effective option for treating lower genital tract conditions as monotherapy or in association with other treatments. The IMQ therapy must be personalized based on physician and patient preference.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":"29 3","pages":"251-262"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}