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Träfflista för sökning "LAR1:lu ;spr:eng;pers:(Dillner Joakim);srt2:(2004)"

Sökning: LAR1:lu > Engelska > Dillner Joakim > (2004)

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  • Arbyn, M, et al. (författare)
  • Virologic versus cytologic triage of women with equivocal pap smears: A meta-analysis of the accuracy to detect high-grade intraepithelial neoplasia
  • 2004
  • Ingår i: Journal of the National Cancer Institute. - Oxford University Press. - 0027-8874. ; 96:4, s. 280-293
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The appropriate management of women with minor cytologic lesions in their cervix is unclear. We performed a meta-analysis to assess the accuracy of human papillomavirus (HPV) DNA testing as an alternative to repeat cytology in women who had equivocal results on a previous Pap smear. Methods: Data were extracted from articles published between 1992 and 2002 that contained results of virologic and cytologic testing followed by colposcopically directed biopsy in women with an index smear showing atypical cells of undetermined significance (ASCUS). Fifteen studies were identified in which HPV triage and the histologic outcome (presence or absence of a cervical intra-epithelial neoplasia of grade 11 or worse CIN2+) was documented. Nine, seven, and two studies also documented the accuracy of repeat cytology when the cutoff for abnormal cytology was set at a threshold of ASCUS or worse, low-grade squamous intraepithelial lesion (LSIL) or worse, or high-grade squamous intraepithelial lesion (HSIL) or worse, respectively. Random-effects models were used for pooling of accuracy parameters in case of interstudy heterogeneity. Differences in accuracy were assessed by pooling the ratio of the sensitivity (or specificity) of HPV testing to that of repeat cytology. Results: The sensitivity and specificity were 84.4% (95% confidence interval CI = 77.6% to 91.1%) and 72.9% (95% CI = 62.5% to 83.3%), respectively, for HPV testing overall and 94.8% (95% CI = 92.7% to 96.9%) and 67.3% (95% CI = 58.2% to 76.4%), respectively, for HPV testing in the eight studies that used the Hybrid Capture 11 assay. Sensitivity and specificity of repeat cytology at a threshold for abnormal cytology of ASCUS or worse was 81.8% (95% CI = 73.5% to 84.3%) and 57.6% (95% CI = 49.5% to 65.7%), respectively. Repeat cytology that used higher cytologic thresholds yielded substantially lower sensitivity but higher specificity than triage with the Hybrid Capture 11 assay. The ratio of the sensitivity of the Hybrid Capture 11 assay to that of repeat cytology at a threshold of ASCUS or worse pooled from the four studies that used both triage tests was 1.16 (95% CI = 1.04 to 1.29). The specificity ratio was not statistically different from unity. Conclusion: The published literature indicates that the Hybrid Capture 11 assay has improved accuracy (higher sensitivity, similar specificity) than the repeat Pap smear using the threshold of ASCUS for an outcome of CIN2+ among women with equivocal cytologic results. The sensitivity of triage at higher cytologic cutoffs is poor.
3.
  • Cubilla, A L, et al. (författare)
  • Malignant epithelial tumors
  • 2004
  • Ingår i: Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. World Health Organization Classification of Tumours. - IARC Press. - 9283224124 ; s. 281
  • Bokkapitel (övrigt vetenskapligt)
4.
  • Dillner, Joakim, et al. (författare)
  • Can genital-tract human papillomavirus infection and cervical cancer be prevented with a vaccine?
  • 2004
  • Ingår i: Expert Rev Mol Med. - Cambridge University Press. - 1462-3994. ; 2004, s. 1-21
  • Tidskriftsartikel (refereegranskat)abstract
    • Human papillomavirus (HPV) infection is the cause of squamous cell carcinoma of the uterine cervix. This causative relationship has provided the rationale and incentive for development of a prophylactic vaccine. Such a vaccine, if found to be effective, could reduce the need for cervical cancer screening and have a profound effect on the incidence of cervical and other anogenital cancers. This review begins by examining the basic biological and epidemiological principles relevant to the development of HPV preventative vaccines. It then summarises studies examining the use of vaccines to prevent HPV infection in animals and humans, and, finally, discusses some of the unanswered issues surrounding vaccine development against HPV infection and cervical cancer.
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  • Naucler, Pontus, et al. (författare)
  • Human papillomavirus genotypes in cervical cancers in Mozambique.
  • 2004
  • Ingår i: J Gen Virol. - Society for General Microbiology. - 0022-1317. ; 85:Pt 8, s. 2189-2190
  • Tidskriftsartikel (refereegranskat)abstract
    • The distribution of human papillomavirus (HPV) types in cervical cancers is essential for design and evaluation of HPV type-specific vaccines. To follow up on a previous report that HPV types 35 and 58 were the dominant HPV types in cervical neoplasia in Mozambique, the HPV types in a consecutive case series of 74 invasive cervical cancers in Mozambique were determined. The most common worldwide major oncogenic HPV types 16 and 18 were present in 69 % of cervical cancers, suggesting that a vaccine targeting HPV-16 and -18 would have a substantial impact on cervical cancer also in Mozambique.
7.
  • Rollman, E, et al. (författare)
  • HPV-16 L1 genes with inactivated negative RNA elements induce potent immune responses.
  • 2004
  • Ingår i: Virology. - 0042-6822. ; 322:1, s. 182-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction of point mutations in the 5' end of the human papillomavirus type 16 (HPV-16) L1 gene specifically inactivates negative regulatory RNA processing elements. DNA vaccination of C57B1/6 mice with the mutated L1 gene resulted in improved immunogenicity for both neutralizing antibodies as well as for broad cellular immune responses. Previous reports on the activation of L1 by codon optimization may be explained by inactivation of the regulatory RNA elements. The modified HPV-16 L1 DNA that induced anti-HPV-16 immunity may be seen as a complementary approach to protein subunit immunization against papillomavirus.
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  • Sundstrom, P, et al. (författare)
  • An altered immune response to Epstein-Barr virus in multiple sclerosis : a prospective study.
  • 2004
  • Ingår i: Neurology. - 1526-632X. ; 62:12, s. 2277-82
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate the association between human herpesviruses and multiple sclerosis ( MS), as well as between measles virus and MS. Methods: The authors identified prospectively collected serum samples from 73 MS cases and retrospective sera from 161 MS cases in two population-based serum bank registers. Analyses of IgG antibody responses in cases and matched referents were performed for Epstein-Barr virus (EBV EBNA-1 and VCA), human herpesvirus 6 (HHV-6), herpes simplex virus (HSV), varicella zoster virus (VZV), and measles. Results: All cases showed signs of past EBV infection. High activity to EBNA-1 and HHV-6 significantly ( borderline significance for HHV-6) increased the risk for MS in prospective sera. A discrepancy between activities to EBNA-1 and VCA was striking in MS samples collected less than 5 years before relapsing-remitting MS onset, where high activity to EBNA-1 significantly increased, and high VCA activity significantly decreased the risk for MS. There was no support for major causal roles for HSV, VZV, or measles. Conclusion: Individuals who will develop MS exhibit an altered immune response against the EBV virus characterized by a high IgG activity to EBNA-1 in the absence of high activity to VCA, this being most pronounced in the 5-year period preceding MS onset.
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