The Papanicolaou test generates pain and embarrassment, and cytology screening has limited sensitivity for detection of cervical neoplasia. These factors urge the use of another screening test that can overcome these limitations. We explore a completely noninvasive method using detection of human papillomavirus (HPV) DNA in women's menstrual blood (MB). The participants were divided into 3 cohorts: (i) 235 patients with cervical intraepithelial neoplasia 3 (CIN 3) (n ‫؍‬ 48), CIN 2 (n ‫؍‬ 60), CIN 1 (n ‫؍‬ 58), or condyloma acuminatum (CAC) (n ‫؍‬ 69) before treatment or remission; (ii) from the first cohort of patients, 108 CIN 3 or CIN 2 patients after treatment and 62 CIN 1 or CAC patients after remission; and (iii) 323 apparently normal subjects (ANS) without any cervical disease. The HPV genotypes of the infected patients were confirmed by direct sequencing. Quantitative real-time PCR (QRT-PCR) was used to measure the MB HPV16 load for 15 infected patients. Results showed that the sensitivity, specificity, and positive and negative predictive values for detection of MB HPV DNA in samples from patients with CIN or CAC were 82.8%, 93.1%, 90.0%, and 87.9%, respectively. Moreover, MB HPV DNA was found in samples from 22.2% of CIN 3 or CIN 2 patients after treatment, 0.0% of CIN 1 or CAC patients after remission, and 8.1% of ANS, 4 of whom were found to have CIN 1 or CAC. Furthermore, QRT-PCR showed that the normalized MB HPV16 DNA copy numbers in samples from patients with CIN 1 to CIN 3 were significantly increased. These preliminary results suggested that MB HPV DNA is a potential noninvasive marker for these premalignant cervical diseases.Cervical cancer (CC) is the second most common malignancy and cause of cancer-related death in women worldwide (17). The well-defined premalignant phase of this cancer has contributed to the success of the cytology-based Papanicolaou (Pap) screening test; the incidence of CC in resource-rich countries has been dramatically reduced by the use of this test (11). However, the Pap test has several limitations: (i) the collection of cervical cells can create discomfort and embarrassment (7); (ii) evaluation of test results in cytology screening involves subjective assessments with high susceptibility to intraindividual and interindividual variability (11); (iii) the test exhibits low (around 51%) sensitivity for detection of highgrade (HG) cervical intraepithelial neoplasia (HGCIN) (11); and (iv) cytology-trained personnel and special equipment with excellent quality control are needed, which involves a huge amount of resources (3). Therefore, there is a need for another cervical screening test that can overcome these limitations. Recent studies have shown that the human papillomavirus (HPV) DNA test is more sensitive than the Pap test in detecting HGCIN (11-13). However, the sample collection method, using a cytobrush, is still invasive and unpleasant, which would affect a woman's decision whether to take the Pap test. We hypothesized that menstrual blood (MB) collected in sani...

The results of this study revealed inadequate knowledge on UCB stem cell banking and its applications among most of our pregnant women. The government and clinicians should combine efforts to provide accurate information on utilization of UCB stem cells during antenatal care.

MB HPV DNA is a potential noninvasive marker for screening and monitoring of squamous intraepithelial lesion. Together with TAP1 I333V and TAP1 D637G gene polymorphisms, the combined test may be useful for stratifying high-risk patients for better follow-up strategies.

We performed a prospective nonrandomized multicentre study to compare laparoscopic surgery and laparotomy in the immediate surgical outcome of tubal ectopic pregnancy (TEP), at 9 teaching hospitals in Hong Kong with a laparoscopic surgical service, on all patients with the operative diagnosis of tubal ectopic pregnancy between July 1, 1996 and June 30, 1997. In the period studied, 630 patients were recruited of which 614 were suitable for analysis. In them, 382 (62.2%) had laparoscopic surgery while the rest had laparotomy with or without diagnostic laparoscopy. Significantly more cases of shock ended in laparotomy (86.1% versus 13.9%). After exclusion of patients with shock, laparoscopic surgery offered a significantly shorter postoperative hospital stay (mean 2.7 days versus 5.3 days), a slightly lower perioperative complication rate (8.1% versus 13.9%) and more conservative surgery (90.1% of all salpingotomies) than laparotomy. A longer operating time was needed for laparoscopic surgery (1.2 hours versus 1.01 hours).

Objectives: Recent evidence has shown that single nucleotide polymorphisms (SNPs) in transporter associated with antigen processing 1 (TAP1) gene includes TAP1 I333V and TAP1 D637G are significantly associated with a protective effect for development of cervical cancer and its pre-malignant states. Hence, TAP1 polymorphisms may potentially be useful to identify women who have less chance to develop high-grade cervical intraepithelial neoplasia (HGCIN) and cervical cancer. Our latest breakthrough in detecting HPV genotypes in the menstrual blood (MB) from patients with CIN and condyloma acuminatum has generated a new era in non-invasive screening for HPV genotypes. Therefore, in this study, we further develop a non-invasive method to predict HGCIN risk in patients with CIN or HPV infection using MB collected in napkin by detecting TAP1 SNP. The information obtained would be important as cervical cancer and CIN are still serious public health problems worldwide especially in developing countries. Materials and Methods: Thirty-eight patients with HGCIN (CIN 2 or 3) and 42 patients with LGCIN (CIN 1) or HPV infection were recruited. MB collected in napkin was put inside ziplock plastic bag which was sent to the laboratory by mail or by hand. Small piece of the napkin was cut out (1 cm x 1 cm x 1 mm) using sterile scissor for DNA extraction. Two SNPs in TAP1 gene (I333V and D637G) were genotyped using polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) technique. The amplified TAP1 gene fragments for I333V and D637G SNP detection were digested by BclI and AccI restriction enzymes, respectively and 3 different genotypes which interpreted as AA (wild type), AG (1 allele showed SNP), and GG (2 alleles showed SNP) were detected at each polymorphic site. Reactions were performed in duplicates and each result was confirmed by DNA sequencing. Results: Both TAP1 polymorphisms in the MB were successfully detected. Their patterns were summarized as a) 3 genotypes at each polymorphic site were detected in our patient cohort (Figure 1, Table 1A); b) the risk to develop HGCIN was significantly reduced for AG and GG genotypes when compared to AA genotype (TAP1 I333V: chi-square test, p = 0.003, odds ratio (OR) = 0.23, 95% confidence interval (CI) = 0.08 to 0.63; TAP1 D637G: chi-square test, p = 0.01, OR = 0.30, 95% CI = 0.12 to 0.76); c) the risk to develop HGCIN was significantly reduced for carriers with a G allele when compared to those with an A allele (Table 1B, TAP1 I333V: chi-square test, p = 0.001, OR = 0.27, 95% CI = 0.12 to 0.62; TAP1 D637G: chi-square test, p = 0.007, OR = 0.36, 95% CI = 0.17 to 0.76). Conclusions: This study is the first to show that MB TAP1 I333V and D637G gene polymorphisms are significantly associated with less risk to develop HGCIN. Acknowledgements: This project was supported by the Direct Grant 2010, The Chinese University of Hong Kong. Citation Format: Sze Chuen Cesar Wong, Thomas Chi Chuen Au, Sammy Chung Sum Chan, Charles Ming Lok Chan, Nancy Bo Yin Tsui, Lawrence Wing Chi Chan, Benjamin Yat Ming Yung. Menstrual blood TAP1 I333V and D637G gene polymorphisms are associated with less risk to develop high-grade cervical intraepithelial neoplasia. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1862. doi:10.1158/1538-7445.AM2014-1862