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Effectiveness of Co-Testing in Cervical Cancer Screening Program in Macao SAR

Health 2024年第8期16卷 763-769页

作者： Lamlam Chan Kamweng Wong centro hospitalar conde de so janurio Macao SAR China

Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Mac

关键词： Cervical Cancer Co-Testing HPV DNA Testing Liquid-Based Cytology Thin Prep Colposcopy Cervical Cancer Screening Program

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Emerging role of liquid biopsy in rat sarcoma virus mutated metastatic colorectal cancer:A case report

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 234-243页

作者： João Gramaça Isabel Gomes Fernandes Carolina Trabulo Joana Gonçalves Rita Gameiro dos Santos Adriano Baptista Idília Pina centro hospitalar Barreiro Montijo Centro Hospitalar Barreiro MontijoSetúbalBarreiro 2830-003Portugal Medical Oncology Unit Centro Hospitalar Barreiro MontijoSetúbalBarreiro 2830-003Portugal

BACKGROUND In patients with metastatic colorectal cancer(mCRC),the treatment options are limited and have been proved to be affected by rat sarcoma virus(RAS)mutational *** RAS wild-type(wt)patients,the combination of antiepidermal growth factor receptor(EGFR)monoclonal antibodies with chemotherapy(CT)is more effective than CT *** the other hand,RAS-mutated patients are not eligible for treatment with anti-EGFR *** SUMMARY Eleven patients with initially RAS-mutated mCRC were followed from diagnosis to May *** the time of cell-free DNA determination,five patients had undergone one CT line,five patients had undergone two CT lines,and one patient had undergone three CT lines(all in combination with bevacizumab).At the second and third treatment lines[second line(2L),third line(3L)],patients with neo-RAS wt received a combination of CT and *** neo-RAS wt patients treated with anti-EGFR,our findings indicated an increase in progression-free survival for both 2L and 3L(14.5 mo,P=0.119 and 3.9 mo,P=0.882,respectively).Regarding 2L overall survival,we registered a slight increase in neo-RAS wt patients treated with anti-EGFR(33.6 mo vs 32.4 mo,P=0.385).At data cut-off,two patients were still alive:A RAS-mutated patient undergoing 3L treatment and a neo-RAS wt patient who received 2L treatment with anti-EGFR(ongoing).CONCLUSION Our case series demonstrated that monitoring RAS mutations in mCRC by liquid biopsy may provide an additional treatment line for neo-RAS wt patients.

关键词： Metastatic colorectal cancer Rat sarcoma virus mutational status Liquid biopsy Rat sarcoma virus wild-type Neo-rat sarcoma virus wild-type Anti-epidermal growth factor receptor therapy Case report

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Colorectal cancer screening:A review of current knowledge and progress in research

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1119-1133页

作者： Sara Ramos Lopes Claudio Martins Inês Costa Santos Madalena Teixeira Élia Gamito Ana Luisa Alves department of Gastroenterology Centro Hospitalar de SetúbalSetúbal 2910-446Portugal

Colorectal cancer(CRC)is one of the most prevalent malignancies worldwide,being the third most commonly diagnosed malignancy and the second leading cause of cancer-related deaths *** the progress in screening,early diagnosis,and treatment,approximately 20%-25%of CRC patients still present with metastatic disease at the time of their initial ***,the burden of disease is still expected to increase,especially in individuals younger than 50 years old,among whom early-onset CRC incidence has been *** and early detection are pivotal to improve CRC-related *** is well established that CRC screening not only reduces incidence,but also decreases deaths from *** screening strategies have proven effective in decreasing both CRC incidence and mortality,though variations in efficacy have been reported across the ***,uncertainties persist regarding the optimal screening method,age intervals and ***,adherence to CRC screening remains globally *** recent years,emerging technologies,notably artificial intelligence,and non-invasive biomarkers,have been developed to overcome these ***,controversy exists over the actual impact of some of the new discoveries on CRC-related outcomes and how to effectively integrate them into daily *** this review,we aim to cover the current evidence surrounding CRC *** will further critically assess novel approaches under investigation,in an effort to differentiate promising inno-vations from mere novelties.

关键词： Colorectal cancer Screening Review Oncology Artificial intelligence

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Perianal disease in inflammatory bowel disease:Broadening treatment and surveillance strategies for anal cancer

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World Journal of Gastroenterology 2024年第28期30卷 3373-3385页

作者： Tatiana Pacheco Sara Monteiro Luísa Barros Jorge Silva department of Gastroenterology Centro Hospitalar do Tamega e SousaPenafiel 4560-136Portugal

The perianal disease affects up to one-third of individuals with Crohn's disease(CD),causing disabling symptoms and significant impairment in quality of life,particularly for those with perianal fistulising CD(PFCD).The collaborative effort between gastroenterologists and surgeons is essential for addressing PFCD to achieve fistula closure and promote luminal *** fistula healing rates with conventional therapies have prompted the emergence of new biological agents,endoscopic procedures and surgical techniques that show promising *** these,mesenchymal stem cells injection is a particularly hopeful *** addition to the burden of fistulas,individuals with perianal CD may face an increased risk of developing anal *** underscores the importance of surveillance programmes and timely interventions to prevent late diagnoses and poor ***,there is no established formal anal screening *** this review,we provide an overview of the current state of the art in managing PFCD,including novel medical,endoscopic and surgical *** discussion also focuses on the relevance of establishing an anal cancer screening programme in CD,intending to propose a risk-based surveillance *** validation of this surveillance programme would be a significant step forward in improving patient care and outcomes.

关键词： Inflammatory bowel disease Crohn's disease Perianal Fistula Anus diseases Management Anal cancer Screening

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Successful cetuximab rechallenge in metastatic colorectal cancer:A case report

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World Journal of Clinical Oncology 2024年第9期15卷 1232-1238页

作者： Alexandra Guedes Sandra Silva Sandra Custódio Andreia Capela department of Medical Oncology Centro Hospitalar Gaia/EspinhoVila Nova de Gaia 4434-502Portugal

BACKGROUND Metastatic colorectal cancer(mCRC)treatment has been evolving and increasingly driven by tumor biology and gene expression *** with epidermal growth factor receptor(EGFR)inhibitors(anti-EGFR)represents a promising strategy for patients with RAS wild-type(RAS-wt)mCRC and circulating tumor DNA has emerged as a potential selection ***,we report the case of a RAS-wt mCRC patient who had a successful response to cetuximab *** SUMMARY Our patient was diagnosed with stage IV RAS-wt,microsatellite-stable rectosigmoid junction *** was started on first-line treatment with FOLFIRI and cetuximab and achieved partial response,allowing for a left hepatectomy(R0),followed by post-operative chemotherapy and an anterior resection;progression-free survival(PFS)of 16 months was *** to hepatic and nodal relapse,second-line treatment with FOLFOX and bevacizumab was started with partial response;metastasectomy was performed(R0),achieving a PFS of 11 *** a 15 months anti-EGFR-free interval,FOLFIRI and cetuximab were reintroduced upon disease progression,again with partial response and a PFS of 16 *** extensive hepatic relapse,cetuximab was reintroduced and a marked clinical and analytical improvement was seen,after only one *** status was confirmed on circulating tumor *** patient’s overall survival exceeded 5 *** Our case provides real-world data to support cetuximab rechallenge in later lines of RAS-wt mCRC treatment.

关键词： Metastatic colorectal cancer RAS mutation RAS wild type Anti-epidermal growth factor receptor Cetuximab Rechallenge Case report

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Clinical results of radical prostatectomy for patients with prostate cancer in Macao

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Chinese Medical Journal 2008年第4期121卷 295-298页

作者： Ho son-fat Lao Hio-fai Li Kin Tse Men-kin department of Urology Centro Hospitalar Conde de Sáo Januário Macao Special Administrative Region China

Background Incidence of prostate cancer has been increasing in recent decades. In the year 2005, prostate cancer became the second most common cancer in males in Macao. The purpose of this report was to review and summarize the clinical features and prognosis of the 54 patients undergoing radical prostatectomy in Macao Special Administrative Region （SAR）, China.Methods From November 2000 to November 2006, retropubic radical prostatectomy were performed in 54 cases for the treatment of prostate cancer. The mean age of patients was 69.8 years （range from 54 to 79）. The preoperative prostate specific antigen （PSA） level, postoperative pathologic stage and Gleason＇s score, operation duration, intraoperative bleeding and intraoperative and postoperative complications were reported. The follow-up duration was 3 months to 6.25 years with a mean of 2.1 years. Postoperative parameters including PSA alteration, biochemical recurrence, local recurrence, distant metastasis and mortality were observed.Results Most of the patients in our study were diagnosed as localized prostate cancer. The patients＇ preoperative serum PSA was 0-4.0 ng/ml （16.7%）, 4.0-10.0 ng/ml （51.8%）, 10.1-20.0 ng/ml （24.1%） and above 20.0 ng/ml （7.4%）. The TNM stage T1a ＋ T1b comprised 7.6% of patients, stage T2a ＋ T2b comprised 20.3%, stage T2c 38.9%, stage T3a 20.3% and over T3a only 12.9%. There were 9.5% cases with Gleason scores of 2-4, 41.5% with scores of 5-6, 30.2% with scores of 7 and 18.8% with scores of 8-10. The average operative duration was 216 minutes and the average intraoperative bleeding was 760 ml. Intraoperative complications included one massive hemorrhage （1.9%）, one rectal injury （1.9%） and one obturator nerve injury （1.9%）. Early postoperative complications consisted of urinary incontinence （14 cases, 25.9%）, bladder neck stricture （5 cases, 9.3%）, acute urinary retention （4 cases, 7.4%）, pelvic effusion （2 cases, 3.8%）, lymphocele （1 case, 1.9%） and vesicorectal fistula （only 1 c

关键词： prostate cancer prostate specific antigen radical prostatectomy

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Basal Cell Carcinoma Excision Guided by dermoscopy:A Retrospective Study in Macao

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International Journal of dermatology and Venereology 2023年第3期6卷 147-149页

作者： Ricardo Coelho Si Leong Cheong department of dermatology Centro Hospitalar Conde de São JanuárioMacao SAR 999078China

Objective:dermoscopic evaluation of tumor margins may help to accurately detect lateral borders before surgical *** purpose of this study was to comprehensively evaluate the usefulness of dermoscopically detecting basal cell carcinoma tumor margins before surgical ***:The authors retrospectively analyzed the outcomes of 60 basal cell carcinomas that were excised after undergoing dermoscopic evaluation of the margins from 2016 to 2018 in a single center in Macao SAR,*** statistical analysis was carried out by using frequencies and ***:All treated tumors were completely excised,although five had safety margins ofdence of ***:Our data suggest that the preoperative dermoscopic evaluation of tumor margins increases the chances of successful and complete tumor excision,while preserving healthy adjacent *** studies comparing dermoscopy-assisted versus conventional excision are needed to better evaluate the value of this technique.

关键词： basal cell carcinoma dermoscopy surgery

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Intraplaque injections of hyaluronic acid for the treatment of stable-phase Peyronie’s disease:a retrospective single-center experience

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Asian Journal of Andrology 2024年第3期26卷 268-271页

作者： Simone Cilio Roberto La Rocca Giuseppe Celentano Claudio Marino Massimiliano Creta Gianluigi Califano Celeste Manfredi Giorgio Ivan Russo Afonso Morgado Marco Falcone Marco Capece YAU Working Group Sexual and Reproductive Health department of Neurosciences Reproductive Sciences and OdontostomatologyUrology UnitUniversity of Naples“Federico II”Naples 80131Italy Urology Unit Department of WomenChild and General and Specialized Surgery“Luigi Vanvitelli”UniversityNaples 80131Italy Urology Section Department of SurgeryUniversityof CataniaCatania 95131Italy department of Urology Centro Hospitalar Universitário São JoãoPorto 4200-319Portugal Urology Clinic-A.O.U.“Cittàdella Salute edella Scienza”-Molinette Hospital University of TurinTurin 10100Italy 不详

Peyronie’s disease(PD)is a condition of penile connective tissue affecting up to 10%of men *** the complexity ofits management,nonsurgical treatments,such as intraplaque injections,are gaining *** current literature shows dataon the efficacy of intraplaque injections of hyaluronic acid(HA)mainly in acute-phase ***,data on injections of HA instable-phase PD are *** for this retrospective study were derived from a prospectively maintained database of privatepatients presenting at a private medical practice affiliated to the University of Naples“Federico II”(Naples,Italy)with stable-phasePD between January 2020 and March *** underwent a standard protocol of three injections,each administered at atwo-week *** the intervals,patients performed vacuum device therapy,penile stretching,and modeling *** compiled the Peyronie’s Disease Questionnaire(PDQ)and Global Assessment of Peyronie’s Disease(GAPD)at baselineand 2 weeks after the third injection.A penile Doppler ultrasound was performed 2 weeks after the last injection to record thefinal ***,we recruited 62 patients with stable-phase PD and a mean(±standard deviation[s.d.])curvature of52.7°(±9.7°).After 6 weeks,eight(12.9%)patients did not experience any curvature *** remaining 54 patientshad a final mean(±s.d.)curvature of 40.3°(±9.1°)with Pdemonstrated that after three injections of HA administered according to the adopted protocol,patientswith stable-phase PD could experience significant improvements in penile curvature,and physical and psychological consequencesof the disease without significantly relevant side effects.

关键词： hyaluronic acid intraplaque injection Peyronie’s disease stable-phase therapy

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Minimizing the risk of community spread of COVID-19 via institutional quarantine of high-risk travelers with serial viral RNA testing: A successful experience from Macao SAR, China

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World Journal of Clinical Cases 2020年第13期8卷 2674-2678页

作者： Chon Fu Lio Hou Hon Cheong Chin Ion Lei Iek Long Lo Chong Lam Iek Hou Leong Macao Academy of Medicine Health BureauMacao SARChina department of Internal Medicine Centro Hospitalar Conde de São JanuárioHealth BureauMacao SARChina department of Respiratory Medicine Centro Hospitalar Conde de São JanuárioHealth BureauMacao SARChina Center for Disease Control and Prevention Health BureauMacao SARChina

Macao,a special administrative region(SAR)of the People’s Republic of China,is located in southern China and shares the border with China's *** is the most densely populated region in the world,with a population of 667400 and a total land area of 32.9 square kilometers in *** the first case diagnosed on January 22,2020,there was a total of 45 laboratory-confirmed coronavirus disease 2019(COVID-19)cases in Macao,of which 43 patients(96%)were imported *** date,all patients had been discharged successfully from centro hospitalar conde de São Januário,a designated hospital to manage all COVID-19 patients in ***,no patient died,and no local community outbreak was *** opinion review describes the underlying factors that could have contributed to the successful experience in Macao SAR,China,which include the following:(1)Early implementation of containment measures;(2)Large-scale quarantine using hotel rooms to reduce the risk of a local outbreak;and(3)Multidisciplinary co-operation and transparency of information to the *** the successful experience in Macao SAR,China,may not be generalized to other regions,it should not be unreasonable to be well prepared with sufficient logistic support to conduct timely containment and early detection of episodic cases to prevent the backsliding of COVID-19 outbreak.

关键词： COVID-19 Macao RNA test Containment Quarantine Outbreak

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Radiofrequency ablation as a treatment for hilar cholangiocarcinoma

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World Journal of Gastroenterology 2008年第28期14卷 4540-4545页

作者： Wei-Jun Fan Pei-Hong Wu Liang Zhang Jin-Hua Huang Fu-Jun Zhang Yang-Kui Gu Ming Zhao Xiang-Long Huang Chang-Yu Guo Cancer Center of Sun Yat-Sen University 651# Dong Feng Dong Road Guangzhou 510060 Guangdong Province China Radiology department Centro Hospitalar Conde de Sao Januario (CHCSJ) Macao SAR CP3002 China

AIM: To explore the role of radio-frequency ablation (RFA) as a treatment for hilar cholangiocarcinoma. METHODS: Eleven patients with obstructive cholestasis underwent Computed Tomography (CT) examination, occupying lesions were observed in the hepatic hilar region in each patient. All lesions were confirmed as cholangioadenocarcinoma by biopsy and were classified as type or by percutaneous transhepatic cholangiography. Patients were treated with multiple electrodes RFA combined with other adjuvant therapy. The survival rate, change of CT attenuation coefficient of the tumor and tumor size were studied in these patients after RFA. RESULTS: In a follow-up CT scan one month after RFA, a size reduction of about 30% was observed in six masses, and two masses were reduced by about 20% in size, three of the eleven masses remained unchanged. In a follow-up CT scan 6 mo after RFA, all the masses were reduced in size (overall 35%), in which the most significant size reduction was 60%. The survival follow-up among these eleven cases was 18 mo in average. Ongoing follow-up showed that the longest survival case was 30 mo and the shortest case was 10 mo. CONCLUSION: RFA is a microinvasive and effective treatment for hilar cholangiocarcinoma.

关键词： Radio-frequency ablation Cholangiocarcinoma Computed tomography

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