Journal of Lower Genital Tract Disease最新文献

{"title":"Evaluation of Host Gene Methylation as a Triage Test for HPV-Positive Women-A Cohort Study.","authors":"Pedro Vieira-Baptista, Mariana Costa, Juliane Hippe, Carlos Sousa, Martina Schmitz, Ana-Rita Silva, Alfred Hansel, Mario Preti","doi":"10.1097/LGT.0000000000000830","DOIUrl":"10.1097/LGT.0000000000000830","url":null,"abstract":"<p><strong>Objectives: </strong>This study was designed to evaluate the performance of a host gene methylation marker panel (ASTN1, DLX1, ITGA4, RXFP3, SOX17, and ZNF671) in the triage of human papillomavirus (HPV)-positive women, its possible impact in a cervical cancer screening program, and the possible influence of the variation of the rate of HPV16/18 in its performance.</p><p><strong>Materials and methods: </strong>Cohort study in which consecutive women referred for colposcopy in an organized cervical cancer screening program had repeated HPV testing, colposcopy, and biopsies. The women that remained HPV positive at the time of colposcopy were tested with the panel of DNA methylation markers. The performance of the test was evaluated and compared to standard practice.</p><p><strong>Results: </strong>The study test had a sensitivity and specificity for cervical intraepithelial neoplasia (CIN) 2+ of 60.8% (49.1-71.6%) and 88.4% (83.2-92.5%), respectively. For CIN3+, it was of 78.0% (64.0-88.5%) and 86.0% (80.8-90.2%), respectively. The rate and level of methylation positively correlated with the severity of disease. The use of methylation reduces the referral for colposcopy to 25.5%, while detecting 78.0% of the CIN3+ cases. Referral of all HPV16/18-positive cases and triage of the other high-risk HPV-positive cases with methylation, detects 90.0% of the cases of CIN3+, while reducing the number of referrals to 43.2%. The variation in the rate of HPV16/18 does not relevantly affect the performance of the methylation panel.</p><p><strong>Conclusions: </strong>The studied methylation panel has a high sensitivity and specificity for CIN3+ and reduces the rate of referrals for colposcopy, without relevant variation according to the rate of HPV16/18.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"326-331"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762196","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":"Vulvar Inspection During Cervical Cancer Screening Procedures: The Ugly Reality.","authors":"Mario Preti, Karin Anderson, Ezio Venturino, Tiziano Maggino, Francesca Carozzi, Eleonora Robba, Pedro Vieira-Baptista, Fulvio Borella, Laura Barchi, Federica Bevilacqua, Niccolò Gallio, Ilaria Barbierato, Benedetta Pollano, Camilla Cavallero, Samuel Gardner-Medwin, Chiara Benedetto, Lauro Bucchi","doi":"10.1097/LGT.0000000000000832","DOIUrl":"10.1097/LGT.0000000000000832","url":null,"abstract":"<p><strong>Abstract: </strong>Vulvar examination during procedures for cervical carcinoma screening (CCS) can be a valid chance for early diagnosis of vulvar diseases and precancerous lesions. With this aim an online questionnaire was sent to the members of the Italian Cervical Carcinoma Screening Group (GISCi) from either first level group (FLG, Pap/human papillomavirus test sampling) or second level group (SLG, colposcopy and treatments) to assess if and how vulvar examination was performed. 86% of FLG and 90.2% of SLG report performing vulvar examination prior to CCS procedures. 15% of SLG cannot manage basic vulvar diseases and they refer patients to specialized center. 54.3% underline lack of standardized protocol in case of vulvar disease detection. Despite most health care professionals report examining the vulva during CCS procedures, vulvar cancer early diagnosis is still challenging.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"391-393"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793919","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":"Hydroxychloroquine for Vulval Lichen Planus.","authors":"Harmony Thompson, Amanda Oakley, Harriet Kennedy","doi":"10.1097/LGT.0000000000000843","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000843","url":null,"abstract":"<p><strong>Objectives: </strong>Vulval lichen planus (VLP) is a chronic inflammatory dermatosis that is often refractory to treatment and results in poor quality of life. The management of recalcitrant disease is not well described in the current literature. Hydroxychloroquine (HCQ) has a role in treating oral and cutaneous lichen planus and may be used in VLP based on expert opinion. This review aimed at adding to the limited existing evidence on the role of HCQ for VLP.</p><p><strong>Materials and methods: </strong>This is a case series of 23 people with VLP treated with HCQ. Outcomes were assessed based on physician global assessment.</p><p><strong>Results: </strong>Twenty-three people with a mean age of 66 years were included. Ten patients (44%) had a much improved response to HCQ, 1 patient (4%) had a partial response, and 7 (30%) had minimal/no response to treatment. Five people (22%) experienced side effects that resulted in stopping HCQ.</p><p><strong>Conclusions: </strong>This series demonstrated some efficacy of HCQ in treating VLP. We are limited by the small participant numbers due to the rarity of this condition and a lack of an objective assessment tool. Further controlled studies are needed to assess the effectiveness and tolerability of HCQ in treating this complex condition.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":"28 4","pages":"394-397"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135870","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":"Statistically Significant Associations Between HPV33, HPV35, and HPV56 With Anal HSIL in a Population of MSMLWH.","authors":"Kamwing Jair,Stephen E Abbott,Annette Aldous,Karina I Rivas,Kaleigh A Connors,David A Klein,Elizabeth S Hoke,Jeanne A Jordan","doi":"10.1097/lgt.0000000000000837","DOIUrl":"https://doi.org/10.1097/lgt.0000000000000837","url":null,"abstract":"OBJECTIVEThe aim of the study is to determine the prevalence of high-risk human papillomavirus (hrHPV) genotypes in men who have sex with other men and are living with HIV and the factors associated with anal high-grade squamous intraepithelial lesions (HSIL).METHODSAnal swabs were collected for hrHPV genotyping from a cross-sectional group (N = 163) of eligible men who have sex with other men and are living with HIV attending a high-resolution anoscopy clinic. Persistent hrHPV infections were studied in a longitudinal subset (n = 37). Association of anal HSIL with specific hrHPV genotype(s) and with HIV-1 suppression was assessed. Pearson's χ2 test with continuity correction or Fisher's exact test was used to determine statistical significance (alpha = 0.05).RESULTSOverall prevalence of hrHPV anal infections was 93.3% (152/163). Higher numbers of hrHPV genotypes were detected per sample in the HSIL group compared with less than or Low-grade squamous intraepithelial lesion (≤LSIL) group (p < .001). Proportion of participants infected with HPV33 was higher in the HSIL group (66.7%) than in ≤LSIL group (33.3%, p < .001), as was HPV35 (61.1% vs. 38.9%, p = .001) and HPV56 (56.7% vs. 43.3%, p = .022). HPV33 persistence was highly associated with HSIL (100%; 8/8) compared with ≤LSIL (0%; 0/8) (p < .001). Proportion of HIV-1 suppression (<200 cp/mL) was significantly lower among the HSIL group (80%; 48/60) compared with ≤LSIL group (95.1%; 97/102) (p = .006).CONCLUSIONSStatistically significant associations existed between anal HSIL and HPV33, HPV35, and HPV56 infections, with HPV33 persistence, and with the lack of HIV-1 suppression. These findings emphasize the critical need for genotyping assays that differentiate more than just HPV16, HPV18 and a pool of \"other\" hrHPV genotypes and that have an intended use with anal specimens. Globally, this highest-risk population would benefit from the 9-valent vaccine to prevent infections and reduce anal cancer risk.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":"10 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142209739","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 the ICD-10 Code for Lichen Sclerosus in Black Women.","authors":"Olushola L Akinshemoyin Vaughn,Precious A Anyanwu,Mariah C Estill","doi":"10.1097/lgt.0000000000000841","DOIUrl":"https://doi.org/10.1097/lgt.0000000000000841","url":null,"abstract":"The prevalence of vulvar lichen sclerosus in Black women is unknown. There is a lack of validity using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code L90.0 to identify women with vulvar lichen sclerosus overall, with less accuracy in Black women.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":"19 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142209740","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":"Awards Presented as Part of the ASCCP 2024 Scientific Meeting on Anogenital & HPV-Related Diseases.","authors":"","doi":"10.1097/LGT.0000000000000824","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000824","url":null,"abstract":"","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":"28 3","pages":"314-315"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136584","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":"Factors Associated With Recent Decline in Anal Health Among Older Gay and Bisexual Men: A Cross-sectional Analysis.","authors":"Sian L Goddard, I Mary Poynten, Kathy Petoumenos, Fengyi Jin, Richard J Hillman, Christopher K Fairley, Suzanne M Garland, Andrew E Grulich, David J Templeton","doi":"10.1097/LGT.0000000000000818","DOIUrl":"10.1097/LGT.0000000000000818","url":null,"abstract":"<p><strong>Abstract: </strong>We investigated factors associated with \"worse than usual\" anal health among gay and bisexual men aged ≥35 years recruited to a longitudinal study of anal human papillomavirus infection/lesions from September 2010 to August 2015.Among 616 participants (median age 49 years; 36% HIV-positive), 42 (6.8%) reported worse than usual anal health in the last 4 weeks. Associated factors included spending less time with gay friends (odds ratio [OR] = 2.25, 95% CI = 1.06-4.77), most time \"feeling down\"(OR = 9.17, 95% CI = 2.94-28.59), reduced libido (OR = 2.90, 95% CI = 1.52-5.52), current anal symptoms (OR = 6.55, 95% CI = 2.54-16.90), recent anal wart diagnosis (OR = 4.33, 95% CI = 1.98-9.49), and fear of developing anal cancer (OR = 9.34, 95% CI = 4.52-19.28).Concerns regarding anal health should be routinely discussed by clinicians, and potentially associated psychosocial, physical, and sexual issues further explored.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"305-309"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867247","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":"Outcome Measures in Adult Vulvar Lichen Sclerosus: A Systematic Review.","authors":"Beth Morrel, Marianne J Ten Kate-Booij, Charlotte van Dijk, Wichor M Bramer, Curt W Burger, Suzanne G M A Pasmans, Irene A M van der Avoort","doi":"10.1097/LGT.0000000000000819","DOIUrl":"10.1097/LGT.0000000000000819","url":null,"abstract":"<p><strong>Objectives: </strong>Core outcome domains (CODs) for treatment of adult vulvar lichen sclerosus (VLS) have recently been established through a Delphi study. A number of measuring tools are available for evaluating VLS. The aim of this study is to identify available standardized measurement tools for the major CODs for VLS that have recently been defined, namely, physical findings and quality of life (QoL) specific to VLS.</p><p><strong>Materials and methods: </strong>A systematic search through September 8, 2023, for measuring tools applicable to VLS regarding physical findings and QoL including sexual function or sexual well-being and self-image was performed.</p><p><strong>Results: </strong>Thirty-five studies were included in the systematic review describing 26 tools covering the following 6 outcome domains: QoL-general health, QoL-lichen sclerosus specific, symptoms, clinical signs, emotional impact, and sexual functioning.</p><p><strong>Conclusions: </strong>In current research, there is no uniformity in use of measurement tools for evaluating VLS. The established CODs to evaluate treatment of VLS are applicable for evaluating disease course as well. A comprehensive study to reach consensus regarding measurement of physical findings, QoL-lichen sclerosus specific, sexuality, and self-image taking the predetermined CODs and other factors such as age into account is needed.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"282-294"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867338","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":"Outcome Measures in Adult Vulvar Lichen Sclerosus: A Case Series of Women Diagnosed as Juveniles.","authors":"Beth Morrel, Marianne J Ten Kate-Booij, Charlotte van Dijk, Colette L M van Hees, Kiki M G J Wigny, Curt W Burger, Suzanne G M A Pasmans, Irene A M van der Avoort","doi":"10.1097/LGT.0000000000000820","DOIUrl":"10.1097/LGT.0000000000000820","url":null,"abstract":"<p><strong>Objectives: </strong>Studies on the consequences of juvenile vulvar lichen sclerosus (JVLS) in adulthood are limited. A number of measuring tools are available for analyzing adult vulvar lichen sclerosus (VLS), but these have not been applied in studies on JVLS. The aim is to study physical findings, quality of life, sexual well-being, and self-image in adult women with a history of juvenile VLS.</p><p><strong>Materials and methods: </strong>Adult women with a biopsy proven history of JVLS were recruited to be examined and surveyed using available standardized measurement tools. This took place in an outpatient setting by physicians who were not involved in the treatment of participants.</p><p><strong>Results: </strong>Twenty-seven women (median age 29 years) with a history of JVLS and median time since biopsy of 19.5 years were recruited. Of these women, 59% currently had symptoms, 63% had signs of active disease, and 85% had moderate to severe architectural changes. Despite these residual signs, vulvar specific-quality of life and vulvar self-image scored favorably while generic health-related quality of life was somewhat effected.</p><p><strong>Conclusions: </strong>JVLS has consequences in adulthood involving physical findings and vulvar quality of life. The use of standardized outcome measures for clinical practice and research purposes facilitates a better understanding of the sequelae to JVLS.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"295-299"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861254","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":"Recommendations for Use of p16/Ki67 Dual Stain for Management of Individuals Testing Positive for Human Papillomavirus: Erratum.","authors":"","doi":"10.1097/LGT.0000000000000825","DOIUrl":"10.1097/LGT.0000000000000825","url":null,"abstract":"","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":"28 3","pages":"316"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472149","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}