Cervical cancer

摘要： Objective: To identify the informational needs of Moroccan women receiving intracavitary brachytherapy for locally advanced cervical cancer as part of a process to develop guidelines for quality patient-centered care. Methodology: A prospective, qualitative study with a phenomenological approach was carried out at the Brachytherapy unit of the National Institute of Oncology in Rabat, Morocco. Purposive sampling was used to recruit 31 patients undergoing high dose-rate brachytherapy for cervical cancer from July 2020 to August 2020. Semi-structured, one-to-one interviews were conducted by a female radiation oncologist in Arabic, guided by a theme list. The interviews were translated and a thematic analysis was performed. Results: Data saturation was achieved having interviewing 31 participants, aged 27 - 70 years. Findings on patients’ informational needs were the overarching theme and form the focus of this article. The informational needs included: providing patients with disease- and treatment-related information in their home language;adequate information concerning pre-treatment preparation, possible side-effects, and sexual intercourse;and providing patients with informative material adapted to their needs as standard procedure. Conclusion: This study has identified unmet women’s informational needs during brachytherapy for cervical cancer. Providing patients with sufficient and understandable information, adequate preparation before the procedure, more sensitive support during the procedure, and debriefing afterward could lessen feelings of fear and anxiety towards treatment delivery. Guidelines with a patient-centered approach could thus be developed to be used as a tool to assist members of multidisciplinary teams in providing quality care to this group of women.

摘要： Background: Radiation therapy has the potential to improve cure rates and provide palliative relief for cervical cancer patients. Despite adherence to radiation therapy being a key treatment modality, patients rarely follow prescriptions. Poor adherence to radiation therapy is associated with low survival and high mortality rates. This study therefore sought to investigate the levels of adherence and factors influencing adherence to radiation therapy among cervical cancer patients being treated at Cancer Diseases Hospital. Methods: A cross-sectional analytical study design was used, 142 patients were selected from the outpatient department using a fishbowl sampling method. A structured interview schedule was used to collect data. Data was entered and analyzed using SPSS, the binary logistic regression analysis was used to predict levels of adherence to treatment and to identify factors associated with adherence to RT among cervical cancer patients. Results: The findings showed that 93% of the participants adhered to radiation therapy while 7% did not adhere to treatment. Majority of the patients 77.1% had experienced side effects of radiation therapy. About 28% of patients had severe psychological distress. By using binary logistic regression, there was a statistically significant association between adherence and perceived quality of health care services (p = 0.001). The analysis showed that patients who perceived poor quality of health care services were 0.005 (99.5%) times less likely to adhere to radiation therapy. The other independent variables were not statistically significant despite being associated with adherence among cervical cancer patients. Conclusions and Recommendations: The findings showed that patients who perceived good quality of health care services had higher chances of adherence compared to those who perceived poor quality of health care services. There is therefore a need for quality service provision which could include good maintenance of radiation machines. Furthermore, there is a need to develop guidelines for follow-up in case of any disease outbreak to avoid interference with patients’ treatment schedules and appointments for reviews.

摘要： BACKGROUND Ubiquilins(UBQLNs)are important factors for cell proteostasis maintenance.UBQLNs are involved in the modulation of the cell cycle,as well as in apoptosis,membrane receptors regulation,DNA repair,epithelial-mesenchymal transition,and mi RNA activities.They also affect the selection of double-strand break repair pathways.Abnormal UBQLNs expression can lead to many diseases,including cancer.Studies have found that the expression of Ubiquilin4(UBQLN4)is associated with the development of several tumor types.However,the association between UBQLN4 and cervical cancer has not been examined yet.AIM To investigate the expression of UBQLN4 in cervical cancer and to evaluate its correlation with disease prognosis.METHODS Immunohistochemistry was performed to examine the expression of UBQLN4 in 117 cervical cancer tissues and 32 matching pericervical tissues.Paired t-test(twotailed)was used to compare the differences between groups.We collected patients’clinical characteristics,including age,histological grade,pathologic type,lymph node metastasis,and FIGO stage(2018)and compared them by chi-square test.All patients were followed for 5.5 to 6.8 years.Kaplan-Meier method and logrank test were used to compare the differences in the overall survival(OS)and progression-free survival(PFS)among the different groups.RESULTS Overexpression of UBQLN4 was observed in 70.9%(83/117)of all cervical cancer tissues and in 15.6%(5/32)of the paired parauterine tissues.The expression of UBQLN4 was associated with lymph node metastasis,poor differentiation,and advanced stage,but the difference was not significant.Kaplan-Meier and log-rank test results suggested the high expression of UBQLN4 was associated with short OS and PFS.Regardless of UBQLN4 expression,the patient age and FIGO stage were also associated with disease prognosis.The statistically significant variables obtained from univariate the Kaplan-Meier analysis were subjected to Cox multivariate survival regression analysis,which showed that,in addition to the FIGO stage and age,UBQLN4 was also an independent prognostic marker for OS and PFS(P=0.011 and P=0.024,respectively).CONCLUSION The overexpression of UBQLN4 was associated with poor prognosis in cervical cancer.Our study proposed a novel prognostic factor and improved the existing understanding of the pathogenesis of cervical cancer.

摘要： Background: Cervical cancer (CC) is the fourth most common cancer in women and those living with HIV have a six times higher risk of cervical cancer compared to those without. The objective of this study was to assess knowledge and perceptions about cervical cancer in women living with HIV/AIDS (WLWHIV) in the municipality of Parakou in Benin. Methods: This was an analytical cross-sectional study conducted among WLWHIV monitored on antiretrovira (ARV) therapy (ART) centers in Parakou. Study participants were selected by systematic random sampling technique. Data collection took place from September 5, 2017 to November 6, 2017. Log-binomial regression was used to identify associated factors. Results: A total of 167 women were recruited into the study. The median age was 35 years [Interquartile range: 41.50 - 30.00]. More than half of the women had no perception of the cause of CC. Only 12.6% of women believed in the preventive capacity of early screening of CC. Among women, 15.6% knew that it can be prevented, but only 9.6% had heard of HPV and 4.8% knew that HPV vaccination is an effective means of preventing CC. The factors associated with the low level of knowledge were the age at first sexual intercourse (≤24 years), the ART follow-up site (private health structure) and the fact of not having visited a maternity hospital in the last 12 months preceding the survey. Conclusion: The perceptions and knowledge about cervical cancer in the population of women living with HIV and monitored on ART in Parakou were inadequate and disproportionate to their vulnerability to this cancer. In order to avoid a double burden on these women, their ART centers must integrate cervical cancer prevention interventions into ART initiation services.

摘要： Background: Cervical Cancer is one such a disease that remains with high mortality unless prevented or detected early and managed. It is one of the most common cancers of the child bearing age between 20 and 45 years world over. It is rated as the second most prevalent cancer among women. There is high consensus among various scholars that high quality screening, effective treatment and routine follow-up care are cardinal in helping women. The main objective of the study was to identify the factors influencing cervical cancer screening in Kitwe District, Zambia. Methods: An analytical cross-sectional study design was employed that included the use of a researcher-administered questionnaire. Simple random sampling was used to sample 210 participants. Data were analyzed using SPSS version 25 and chi-square test was used to determine associations among variables. Binary logistic regression was used for multivariate analysis. Statistical significance was set at p Results: The age of the women enrolled in the study ranged from 20 to 59 years, with a mean age of 30.4 years (SD: 8.36). Majority (46.2%) of the women were aged between 25 to 34 years and the mean age reported for sexual debut among respondents was 19.7 (SD: 4.01) years ranging from 12 to 31 years at first sexual encounter. Almost all (99%) the women were Christians and 42.9% had attained secondary school education. Fifty nine (59%) of the respondents were married and 77.6% had children. Over three quarters (77.6%) of the respondents were knowledgeable on cervical cancer and screening, majority (61%) of the respondents demonstrated a more positive attitude towards cervical cancer screening, and the overall perception level among study respondents was more positive (71.9%). The findings of the present study indicated that the magnitude of cervical cancer screening was 44.8%. In the binary logistic regression analysis, older age (35 to 44 years: AOR = 10.91, 95% CI: 2.67 - 44.48, p = 0.001;45 to 59 years: AOR = 10.28, 95% CI: 1.52 - 69.68, p = 0.017, respectively), and having a positive attitude (AOR = 67.5, 95% CI: 15.42 - 295.44, p < 0.001) were independently associated with cervical cancer screening utilization. Conclusion: The study has shown that despite women having adequate knowledge, positive attitudes and perceptions, the number of women who had been screened was still low. However, middle aged and older women, and positive attitudes were found to independently influence women to go for cervical cancer screening. Therefore, attempts should be made to reach women who rarely visit health care services, for example, through increasing health campaigns in partnership with other organizations in the area.

摘要： Purpose: To evaluate the anxiety and pain levels of cervical cancer patients undergoing intracavitary multifraction high-dose rate (HDR) brachytherapy, as part of a process to develop guidelines for quality patient-centered care. Methods: Cervical cancer patients (n = 31) undergoingmultiple fraction HDR brachytherapy treatment at the National Institute of Oncology in Rabat (Morocco) completed ratings of pain and anxiety intensity using 11-point verbal analog scales, at 6 key time points over 2 brachytherapy insertion procedures and 4 brachytherapy fractions. Women were evaluated for psychological status at baseline before starting the brachytherapy process using the Hospital Anxiety and Depression Scale (HADS). Scores were grouped as follows: 0 - 7 = normal, 8 - 10 = borderline, 11 - 21 = abnormal. Factors that could affect anxiety levels such as education level, relationship status, number of pregnancies and prior surgical history were documented. Results: Between July and August 2020, 31 women with a median age of 49.6 years were evaluated (range: 27 - 70). The HADS score identified depression in 5 patients (16.1%) and anxiety in 12 patients (38.7%). Throughout both treatment procedures, anticipatory anxiety was reported, with a maximum intensity in the operating room during spinal anesthesia (3.23 ± 1.7) and during applicator insertion (2.97 ± 2.4). Moderate-to-severe anxiety scores were reported in 25.8% and 22.6% of patients respectively. Level of education showed a significant correlation with anxiety scores (p = 0.027). Pain increased significantly during the procedure (p ± 1.4) and applicator removal (4.74 ± 1.5) turned out to be the most painful parts of the procedure. No correlation was found between pain and anxiety levels. Conclusion: Intracavitary multifraction high-dose rate brachytherapy is associated with mild to moderate levels of pain and anxiety, although a subset of patients reported more severe symptoms and may require additional medical and psychological support, with particular emphasis on bed-rest duration and applicator removal. The development of effective interventions (both pharmacological and non-pharmacological) is needed to improve women’s experiences of brachytherapy for locally advanced cervical cancer.

摘要： Cervical cancer has a high mortality rate in clinic.This disease seriously threatens the physical and mental health and life safety of patients.At present,radical surgery is mainly used for treatment,but in order to reduce the incidence of intraoperative and postoperative complications,corresponding nursing needs to be coordinated.This time focuses on the complications after radical surgery for cervical cancer,and puts forward the nursing methods of common complications of transabdominal radical surgery for cervical cancer.In order to improve the quality of nursing and life of patients,this paper summarizes the effective implementation of the whole process nursing model after cervical cancer surgery.

摘要： Objective: The aim of this study was to establish cervical cancer patients’ expectations and experiences during high dose-rate (HDR) intracavitary brachytherapy procedure, as part of a process to develop guidelines for quality patient-centered care. Methodology: A prospective, qualitative study with a descriptive phenomenological approach was used. Purposive sampling was carried out to recruit 31 women undergoing HDR brachytherapy for cervical cancer from June to August 2020 at the National Institute of Oncology in Rabat. Semi-structured, one-to-one interviews guided by a theme list were conducted by a female radiation oncologist in Arabic before, during and after treatment. The following aspects were discussed: expectations, experiences in the waiting room, in the treatment room, and suggestions for improvement. Data was transcribed, translated and thematic analysis performed. Results: Most of the patients felt unprepared and did not have a clear understanding of brachytherapy. Brachytherapy was a difficult experience causing fear and anxiety throughout treatment. Most women dreaded the procedure, before receiving the first treatment and even after having had one. Pain was a major problem for the participants. Some women compared this pain to childbirth, a process they preferred to brachytherapy. Patients agreed that the preventative medication received was not efficient to relieve the pain. Despite these negative experiences, patients were left with a positive outlook. Dialogue with the healthcare professionals, support from their family and fellow patients, envisaged outcomes and desires to heal were used to cope, whilst faith and spirituality gave them strength to endure the procedure. Conclusion: Women undergoing uterovaginal brachytherapy for cervical cancer experience pain and emotional distress. Providing patients with adequate information, more sensitive support during the procedure and debriefing afterwards could lessen feelings of fear and anxiety. Our findings advocate for the revision of pain management protocols. Further studies should be carried out to define patient-centered recommendations and provide quality care to this group of women.

摘要： The Double Ribbons campaign is a combination of the pink ribbon and the blue ribbon.China has launched the"Double Ribbon Campaign,"which includes free screening for both breast and cervical cancers.In this paper,by briefly describing the characteristics of breast cancer and cervical cancer,this paper summarizes the screening data of Changle County People's Hospital in Shandong Province in the past ten years,clarifies the importance of early screening,early diagnosis and early treatment of diseases,summarizes experience,defines goals,and promotes the long-term development of China's health cause.

摘要： Background:Long non-coding RNAs(lncRNAs)can influence the necroptosis process,which is essential in malignant tumors.But no studies have looked at the predictive value of necroptosis-related lncRNAs in cervical cancer(CC).Using necroptosis-related lncRNAs,we developed a prediction signature to predict the prognosis of CC patients.Method:We gathered the RNA-seq and related clinical data for patients with CC from the Cancer Genome Atlas(TCGA)database.To identify lncRNAs linked to necroptosis,we then conducted univariate and multivariate Cox regression analyses.Co-expression network analysis,least absolute shrinkage selection operator(LASSO)regression analysis and multivariate Cox regression analyses were subsequently used to further filter necroptosis-related lncRNAs signature and construct a predictive model.Finally,we examined the medication sensitivity between the two risk groups.We performed a single-sample gene set enrichment analysis(ssGSEA)to investigate the association between the predictive signature and the tumor immune microenvironment.Result:Six necroptosis-related lncRNAs(AL021807.1,AC026803.2,AC015819.1,AC233728.1,AL158166.1,NKILA)that are independently connected to the overall survival(OS)time of CC patients make up the signature we created.For predicting the 1-,3-,and 5-year survival rates,the areas under the receiver operating characteristic(ROC)curve(AUC)were 0.72,0.791,and 0.808.It was determined that the risk score model was a separate prognostic component.The Kaplan-Meier analysis revealed that the prognosis for CC patients in the high-risk category was worse.Low-risk CC patients had more active immune systems and responded better to PD1/L1 immunotherapy.Conclusion:The signature based on necroptosis-related lncRNAs is a reliable biomarker,which is more likely to independently predict the prognosis of patients with CC and offer a foundation for the pathogenesis of necroptosis-related lncRNAs in CC.It can also be utilized to direct the tailored therapy of CC patients.