Annals of medicine最新文献

{"title":"Risk factors for periprosthetic femoral fractures following hip arthroplasty: a systematic review and meta-analysis.","authors":"Wei-Qiang Zhao, Ke-Qin Yu, Rong-Zhen Xie, Yu-Feng Liang, Jie-Feng Huang","doi":"10.1080/07853890.2025.2494679","DOIUrl":"https://doi.org/10.1080/07853890.2025.2494679","url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic femoral fracture (PPFF) is a serious complication following hip arthroplasty. The objective of this study was to determine the risk factors for PPFF following hip arthroplasty from existing studies.</p><p><strong>Methods: </strong>A comprehensive systematic search was performed in 4 databases: Pubmed, Embase, Web of Science, and Cochrane Library. The last search was carried out on 26th July 2024. We focused on identifying risk factors for PPFF following hip arthroplasty. Study eligibility required PPFF as an outcome and reporting of associated risk factors. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS), with evidence certainty evaluated via Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Meta-analyses employed both fixed-effect and random-effects models to pool odds ratios for identified risk factors.</p><p><strong>Results: </strong>Out of 1553 articles, 36 studies published between 2006 and 2024 were included. Risk factors associated with increased incidence of PPFF ranges from very Low to High. High-quality evidence supported the use of uncemented stems (Odds Ratio [OR]: 3.36, 95% Confidence Interval [95% CI]: 3.02-3.74), major teaching hospital (OR: 2.04, 95% CI: 1.37-3.05). Moderate-quality evidence: female gender (OR: 1.60, 95% CI: 1.43-1.78), morbid obesity (OR: 1.44, 95% CI: 1.01-2.16), higher Deyo-Charlson index (OR: 1.44, 95% CI: 1.18-1.77), rheumatoid arthritis (OR: 1.89, 95% CI: 1.16-3.06), femoral Dorr type C (OR: 4.23, 95% CI: 2.82-6.33). Low evidence: age > 70 years (OR: 1.67, 95% CI: 1.19-2.34), revision hip arthroplasty (OR: 2.60, 95% CI: 1.59-4.27). BMI > 30 and history of hip surgery are not the risk (very low). Diagonized as osteoarthritis before surgery is a protective factor (OR:0.51, 95%CI: 0.40-0.65, quality = High).</p><p><strong>Conclusion: </strong>This meta-analysis provided some low-to-high evidence about the risk of PPFF following hip arthroplasty. It's recommended that clinicians consider these risk factors when evaluating patients for hip arthroplasty and take steps to mitigate their impact, like optimizing patients health preoperatively, using cemented stems, and monitoring high-risk patients closely.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2494679"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for delayed gastric emptying after pancreatoduodenectomy: a 10-year retrospective study.","authors":"Carlos Jiménez-Romero, Agustín de Juan Lerma, Alberto Marcacuzco Quinto, Oscar Caso Maestro, Laura Alonso Murillo, Paula Rioja Conde, Iago Justo Alonso","doi":"10.1080/07853890.2025.2453076","DOIUrl":"10.1080/07853890.2025.2453076","url":null,"abstract":"<p><strong>Background: </strong>Delayed gastric emptying (DGE) is a frequent complication of pancreatoduodenectomy (PD) and is associated with prolonged hospital stay, readmission, increased hospital costs and decreased quality of life. However, the pathophysiology of DGE remains unclear.</p><p><strong>Methods: </strong>This is a retrospective study of patients who underwent PD for pancreatic or periampullary tumours. All these patients were operated between January 2012 and February 2023. The patients were divided into four groups according to the development of DGE after PD: No DGE, DGE grade A, DGE grade B and DGE grade C. The groups were compared in terms of outcomes and complications. We also analysed the preoperative and perioperative risk factors for DGE development.</p><p><strong>Results: </strong>Between January 2012 and February 2023, a total of 250 patients underwent PD. These patients were divided into four groups: No DGE (<i>n</i> = 152); DGE grade A (<i>n</i> = 42); DGE grade B (<i>n</i> = 45); and DGE grade C (<i>n</i> = 11). The incidence of the postoperative pancreatic fistulas (POPFs) grade B/C was significantly higher in the DGE grade C group (<i>p</i> < .001), and the rates of post-pancreatectomy haemorrhage (<i>p</i> = .004) and reoperation (<i>p</i> < .001) were significantly higher in the DGE grade B/C groups. A significantly higher rate of grade III-IV Clavien-Dindo complications (<i>p</i> < .001), longer intensive care unit (<i>p</i> < .001) and longer hospital stays (<i>p</i> < .001) were observed in the DGE grade C group; and 90-day mortality (<i>p</i> < .001) and morbidity (<i>p</i> < .001) were significantly higher in the DGE grade B/C groups. Multivariate analysis demonstrated that the POPF grade B/C was a risk factor of DGE grade B/C (OR: 9.147; 95%CI: 4.125-20.281; <i>p</i> < .001).</p><p><strong>Conclusions: </strong>POPF B/C is a risk factor for grade B/C DGE. Prevention of surgical complications and early treatment could contribute to the decreased incidence of DGE.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2453076"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a postoperative survival scoring index for adult liver transplantation.","authors":"Shuai Wang, Xiaohong Lin, Yefu Li, Zhonghao Xie, Ming Zhang, Yicheng Liang, Chuchen Zhu, Yuqi Dong, Ping Zeng, Xiaoshun He, Weiqiang Ju, Maogen Chen","doi":"10.1080/07853890.2025.2458212","DOIUrl":"10.1080/07853890.2025.2458212","url":null,"abstract":"<p><strong>Background: </strong>In addition to surgical technology, successful liver transplantation (LT) depends on perioperative management, which needs an effective prognostic index. Therefore, a simplified and sensitive postoperative index for adult LT should be developed.</p><p><strong>Methods: </strong>In total, 906 patients who underwent LT were included in this cross-sectional study. Univariate analysis was used to identify the independent risk factors for recipient survival. Multivariate logistic and stepwise regression analyses were used to construct and simplify the model design. Area under the curve (AUC) and Kaplan-Meier's (K-M) analysis demonstrated superiority of the new index. The postoperative survival score (POSS) index was further simplified via restricted cubic spline (RCS) analysis. Finally, the interpretation of the long-term mortality and subgroup analyses extended the application of the POSS index.</p><p><strong>Results: </strong>Finally, a total of five factors (donor sex, recipient body mass index (BMI), total bilirubin (Tbil), international normalized ratio (INR) and total operative time) were identified as independent risk parameters and included in our POSS index. The AUCs of the original and simplified POSS indices were 0.764 and 0.723, respectively. Patients with high scores had poor short-term survival. Our index also functioned well in predicting long-term mortality, and it was more effective for patients with hepatitis B cirrhosis or hepatocellular carcinoma (HCC).</p><p><strong>Conclusions: </strong>We constructed a simplified and effective postoperative survival scoring index to predict short-term complications and survival in adult LT patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2458212"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding East-West differences in subsolid nodules: prevalence and overdiagnosis implications in lung cancer screening.","authors":"Yeun-Chung Chang, Yi-Chi Hung, Yun-Ju Wu, En-Kuei Tang, Fu-Zong Wu","doi":"10.1080/07853890.2025.2478321","DOIUrl":"10.1080/07853890.2025.2478321","url":null,"abstract":"<p><strong>Background: </strong>Owing to the widespread opportunistic LDCT screening leading to increased overdiagnosis in Asian countries, such as South Korea, mainland China, and Taiwan, this study seeks to analyze the divergence in SSN prevalence between Eastern and Western nations, focusing on the influence of SSN on the growing overdiagnosis trend, notably among females.</p><p><strong>Methods: </strong>This retrospective study collected data from 4166 participants who underwent baseline LDCT in a hospital-based cohort between January 2014 and August 2021. Clinical parameters, including age, sex, lung imaging reporting and data system (Lung-RADS) categories, smoking history, pack-year dose, and SSN characteristics, were extracted from electronic medical records. Additionally, a narrative review and pooled analysis integrated relevant published studies on the prevalence of subsolid nodules and sex disparities.</p><p><strong>Results: </strong>The study encompassed 4166 participants, with females accounting for 49.3% and males for 50.7%, with a mean age of 53.38 ± 10.89. The prevalence of SSNs was significantly higher in females (20.1%) than in males (12.6%). Pooled analysis across seven studies revealed a significantly higher prevalence of SSN in Eastern countries (12.6%) compared to the prevalence in Western countries (3.6%) (test for subgroup differences: <i>p</i> < 0.01; I² = 100%). Additionally, a notable sex difference was observed in the prevalence of SSNs (risk ratio = 0.489, 95% CI: 0.301-0.796, <i>p</i> < 0.01; reference group: male group).</p><p><strong>Conclusions: </strong>Apart from differences in clinical management and health literacy regarding SSNs between Eastern and Western countries, the high prevalence of SSNs in Asian nations, particularly among females, significantly contributes to the issue of overdiagnosis in opportunistic lung cancer screening in Asian countries. Tailored sex-specific strategies and risk prediction models are essential for effective screening optimization.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2478321"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting cervical cancer screening and human papilloma virus vaccination among Middle Eastern refugee women in Türkiye: indicators for social workers and nurses.","authors":"Yaser Snoubar, Baraka Abusafia, Zekiye Turan","doi":"10.1080/07853890.2025.2468261","DOIUrl":"10.1080/07853890.2025.2468261","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to generate knowledge regarding factors affecting cervical cancer screening and human papillomavirus vaccination that can be used practically by social workers and nurses while working with Middle Eastern refugee women living in Türkiye.</p><p><strong>Methods and results: </strong>This study involved the administration of a self-reported questionnaire to 227 female migrants. It identified sociodemographic variables, such as age, marital status, and education level, that influenced the participation of these women in preventive practices against cervical cancer. Despite their cultural beliefs, financial constraints, and language hurdles, the findings indicated that the likelihood of involvement in screening and vaccination for cervical cancer was greater among refugee women if they were well-informed and assisted.</p><p><strong>Conclusions: </strong>The results of this study suggest the necessity for specific training programs and improved initiatives for healthcare access to prevent cervical cancer among vulnerable groups. Healthcare providers can support preventive measures more effectively if these concerns are addressed with consideration of the sociocultural elements and language issues among Middle Eastern refugee women. Although some limitations associated with self-reported data collection methods may have introduced response bias, this study showed how social workers and nurses can act as facilitators to prevent cervical cancer.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2468261"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainability in food-based dietary guidelines: a review of recommendations around meat and dairy consumption and their visual representation.","authors":"Maddie Sinclair, Emilie Combet, Tess Davis, Esther K Papies","doi":"10.1080/07853890.2025.2470252","DOIUrl":"10.1080/07853890.2025.2470252","url":null,"abstract":"<p><strong>Background: </strong>The transition away from high meat and dairy consumption and towards more plant-based diets is vital for environmental sustainability targets, including reducing greenhouse gas (GHG) emissions and land use associated with food. Food-based dietary guidelines (FBDG) communicate nutrition information to a country's general public. However, it is unknown how different countries' FBDG communicate reducing meat and dairy intake in the context of sustainability.</p><p><strong>Methods: </strong>To address this gap, we reviewed global consumer-facing FBDG (<i>n</i> = 58) in middle- and high-income countries to examine recommendations and information around meat and dairy consumption, and to explore the pictorial representation of these foods.</p><p><strong>Results: </strong>Few countries used a sustainability argument to recommend reducing meat (6/58) or dairy consumption (2/58). The proportion of dairy images within food guides was consistently higher than meat images. Some countries' guidelines are starting to consider meat intake in the context of sustainability and implementing meat reduction recommendations. However, this is not the case for dairy, potentially due to complex nutritional implications.</p><p><strong>Conclusion: </strong>Overall, our review shows that very few countries recommend reducing either meat or dairy consumption. To reduce the environmental impact of food systems, clearer guidelines backed by current evidence are needed, which provide justification behind recommendations, actionable advice for how to meet the recommendations, and appropriate quantified food targets or limits. This well-rounded advice is imperative to empower citizens to take action on their dietary habits, to reduce global meat and dairy consumption and replace these with more sustainable alternatives for human and planetary health.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2470252"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educating women to prevent and treat low back and pelvic girdle pain during and after pregnancy: a systematized narrative review.","authors":"Sabine Vesting, Annelie Gutke, Liesbet de Baets","doi":"10.1080/07853890.2025.2476046","DOIUrl":"10.1080/07853890.2025.2476046","url":null,"abstract":"<p><strong>Purpose: </strong>This review evaluated the effectiveness of patient education and information on low back pain (LBP) and pelvic girdle pain (PGP) in pregnant and postpartum women and evaluated their alignment with modern pain education principles rooted in the biopsychosocial model.</p><p><strong>Method: </strong>A systematized narrative review was performed, including a systematic search of three databases and reference screening from relevant systematic reviews. The methodological quality of the included randomized controlled trials (RCT) was evaluated using the PEDro scale.</p><p><strong>Results: </strong>Eighteen studies, including nine RCTs with PEDro scores ranging from to 2-8, indicated that patient education during pregnancy can help reduce pain and related disability. Most studies did not differentiate between LBP and PGP, which limits the specificity and targeted approach of educational interventions. Education alone is less effective without accompanying active treatment. Current programs primarily emphasize biomechanics, covering anatomy and physical changes, but often neglect lifestyle factors, such as stress and sleep.</p><p><strong>Conclusion: </strong>Although patient education is important for managing pregnancy-related LBP and PGP, its effectiveness may be improved by tailoring programs to specific pain conditions and integrating a biopsychosocial perspective on pain.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2476046"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing vaginal natural orifice to facilitate bowel manipulation during totally intracorporeal ileal conduit construction: a retrospective cohort study.","authors":"Kaipeng Jia, Shiwang Huang, Zhun Wang, Yuda Lin, Yiduo Bai, Chong Shen, Zhe Zhang, Zhouliang Wu, Yunkai Qie, Hailong Hu","doi":"10.1080/07853890.2025.2453827","DOIUrl":"10.1080/07853890.2025.2453827","url":null,"abstract":"<p><strong>Objective: </strong>To explore the feasibility and efficacy of the modified technique of totally intracorporeal ileal conduit (IC) construction <i>via</i> vaginal approach following robot-assisted radical cystectomy (RARC) in females.</p><p><strong>Methods: </strong>By comparing the perioperative outcomes of the modified technique with extracorporeal urinary diversion (ECUD), 31 females treated for bladder cancer with RARC and IC from May 2020 to December 2023 were retrospectively analyzed and divided into two groups: the ECUD group (10 patients) and the modified intracorporeal urinary diversion (MICUD group) (21 patients). The modified technique involved performing transvaginal natural orifice specimen extraction surgery (TV-NOSES) after RARC; followed by the transvaginal placement of an Endo-GIA stapler to manipulate the bowel for intracorporeal IC construction.</p><p><strong>Results: </strong>Both groups' surgeries were successfully completed by the same surgeon and team. Patients in the MICUD group had shorter total operative time, lower postoperative pain scores, quicker recovery, and shorter hospital stays. The learning curve of the MICUD showed two phases: a learning phase (cases 1-7) and a proficiency phase (cases 8-21). The incidence of postoperative complications between the two groups was similar. The mean follow-up times were 29.3 months (ECUD group) and 22.6 months (MICUD group). In the MICUD group, there was one case of local tumor recurrence, two cases of distant metastasis, including one death from progression; in the ECUD group, one patient had distant metastasis and died from progression.</p><p><strong>Conclusion: </strong>RARC with MICUD represents a safe, feasible and easy-to-learn minimally invasive surgical approach. Patients experience less trauma and faster recoveries.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2453827"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examined lymph node counts affected the staging and survival in cervical cancer: a retrospective study using the SEER and Chinese cohort.","authors":"Tao Guo, Yuxi Zhao, Jia Zeng, Jian Li, Enyu Tang, Lingying Wu","doi":"10.1080/07853890.2025.2459821","DOIUrl":"10.1080/07853890.2025.2459821","url":null,"abstract":"<p><strong>Background: </strong>The impact of examined lymph node (LN) count on survival in cervical cancer remains understudied, with no consensus on the optimal number required.</p><p><strong>Objectives: </strong>We aimed to investigate the role of LN count in postoperative pathological evaluation for cervical cancer patients undergoing surgery.</p><p><strong>Methods: </strong>Data from the US SEER database and a retrospective Chinese cohort were analyzed. Multivariable logistic and Cox regression models assessed LN positivity detection and overall survival (OS), respectively. Smoothing spline curves and Chow tests identified structural change points in hazard ratios and LN-positive ratios.</p><p><strong>Results: </strong>Among 14,133 SEER and 2,811 Chinese cases, higher LN counts correlated with increased detection of positive LNs (OR: 1.040, 95% CI: 1.019-1.062) and improved OS (HR: 0.990, 95% CI: 0.984-0.996). Structural change points occurred at 20 LNs for LN-negative patients and 13 LNs for LN-positive patients (both P < 0.001). An elevated LN-positive ratio (positive/examined LNs) strongly predicted worse OS (HR: 4.208; 95% CI: 1.454-12.181).</p><p><strong>Conclusions: </strong>An increased number of examined LNs significantly contributes to the detection of positive LNs and improved patient survival. For patients with claimed LN-negative and LN-positive disease, a minimum examination of 20 and 13 LNs, respectively, is recommended to ensure adequate LN evaluation. The LN positive ratio is a strong prognostic indicator in patients with LN-positive disease.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2459821"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytology.","authors":"Xuan Rao, Yue-Han Wang, Rui-Zhe Chen, Qian-Qian Wu, Xiao-Fei Zhang, Yun-Feng Fu, Xin-Yu Wang, Xiao Li","doi":"10.1080/07853890.2025.2451183","DOIUrl":"10.1080/07853890.2025.2451183","url":null,"abstract":"<p><strong>Objective: </strong>We attempted to evaluate the immediate high-grade squamous intraepithelial lesion-cervical intraepithelial neoplasia grade 2/3 or worse (HSIL-CIN2+/3+, hereafter referred to as CIN2+/3+) risk of specific human papillomavirus (HPV) genotype and form the precise risk-based triage strategy for atypical squamous cells of undetermined significance (ASC-US) women.</p><p><strong>Methods: </strong>The clinical data of ASC-US women who underwent HPV genotyping testing and colposcopy were retrospectively reviewed. The distribution and CIN2+/3+ risks of specific HPV genotype were assessed by three approaches. The risk-based triage strategy was further established, and its efficacy in detecting CIN2+/3+ was estimated.</p><p><strong>Results: </strong>Totally, 5553 ASC-US women including 3648 HPV-positive and 1905 HPV-negative were analysed. CIN2+/3+ were 662/319 cases, including 639/306 HPV-positive and 23/13 HPV-negative women. HPV16, HPV52, HPV58 and HPV18 were always among the top 5 ranking genotypes, no matter in HPV-positive women or in HPV-positive CIN2+/3+ cases. HPV16 and HPV33 carried the highest risk, while HPV73 and 26 carried the least risk for CIN2+/3+. Based on the immediate CIN2+/3+ risk of specific HPV genotype, 18 HPVs were divided into three risk-stratified groups. Only women infected with HPVs included in group A were necessary for immediate colposcopy. Compared with conventional strategy, this new risk-based strategy not only had higher specificity (CIN2+: <i>p</i> = .00; CIN3+: <i>p</i> = .01) and positive predictive value (CIN2+: <i>p</i> = .00; CIN3+: <i>p</i> = .03) for detecting CIN2+/3+, but also needed fewer colposcopies to identify each CIN2+/3+.</p><p><strong>Conclusions: </strong>A new triage strategy for ASC-US women was successfully constructed based on CIN2+/3+ risks of 14 high-risk and 4 intermediate-risk HPVs, which could significantly reduce unnecessary colposcopies.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2451183"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}