Rozprawy doktorskie na temat „Cervical Cancer”
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1
Ibrahim, Emad Moussa. "CD44 in cervical cancer". Thesis, University of Sheffield, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269370.
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Thornton, Julia Susan. "Screening for cervical cancer". Thesis, City University London, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241442.
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Nevin, James. "Pregnancy-associated cervical cancer". Thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/26272.
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Ratima, Keri, i n/a. "Cervical cancer in Maori women". University of Otago. Dunedin School of Medicine, 1994. http://adt.otago.ac.nz./public/adt-NZDU20070601.112003.
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This thesis is concerned with cervical cancer amongst New Zealand women, particularly Maori women. Maori women have an alarmingly high incidence of cervical cancer, approximately three times higher than non-Maori women. Maori women experience one of the highest rates of cervical cancer in the world.
Chapter one, two and three form the introductory section of the thesis, Section A. Chapter one provides an overview of cervical cancer incidence in the world, followed by a more detailed analysis of the occurrence of cervical cancer in New Zealand and a discussion of the aetiological factors of cervical cancer. Cervical screening is discussed in Chapter two. The ethnic differences in incidence and mortality of cervical cancer between Maori and non-Maori and possible reasons for these differences are studied in Chapter three.
Section B consists of the original work undertaken. A pilot study (Chapter four) was conducted to trial the methods for the national study (Chapter five). The national study was a retrospective review of the cervical smear histories of Maori women first diagnosed with invasive cervical cancer over a recent two year period in order to investigate why Maori women have not had their disease detected by screening and treated at the intraepithelial stage. Maori women�s knowledge of and attitudes towards cervical screening were obtained in a survey in Ruatoria (Chapter six).
Section C concludes with a chapter (Chapter seven) on the conclusions and recommendations based on the material reviewed and the work undertaken.
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Govorukhina, Natalia I. "Biomarker discovery for cervical cancer". [S.l. : Groningen : s.n. ; University Library of Groningen] [Host], 2007. http://irs.ub.rug.nl/ppn/305362089.
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Roeder, Geraldine Elizabeth. "Gene therapy for cervical cancer". Thesis, University of Bristol, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268704.
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Li, Xing. "Novel brachytherapy techniques for cervical cancer and prostate cancer". Diss., University of Iowa, 2015. https://ir.uiowa.edu/etd/1682.
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Intensity-modulated brachytherapy techniques, compensator-based intensity modulated brachytherapy (CBT) and interstitial rotating shield brachytherapy (I-RSBT), are two novel conceptual radiation therapies for treating cervical and prostate cancer, respectively. Compared to conventional brachytherapy techniques for treating cervical cancer, CBT can potentially improve the dose conformity to the high-risk clinical target volume (CTV) of the cervix in a less invasive approach. I-RSBT can reduce the dose delivered to the prostate organ at risks (OARs) with the same radiation dose delivered to the prostate CTV. In this work, concepts and prototypes for CBT and I-RSBT were introduced and developed. Preliminary dosimetric measurements were performed for CBT and I-RSBT, respectively.
A CBT prototype system was constructed and experimentally validated. A prototype cylindrical compensator with eight octants, each with different thicknesses, was designed. Direct metal laser sintering (DMLS) was used to construct CoCr and Ti compensator prototypes, and a 4-D milling technique was used to construct a Ti compensator prototype. Gafchromic EBT2 films, held by an acrylic quality assurance (QA) phantom, were irradiated to approximately 125 cGy with an electronic brachytherapy (eBT) source for both shielded and unshielded cases. The dose at each point on the films were calculated using a TG-43 calculation model that was modified to account for the presence of a compensator prototype by ray-tracing.
With I-RSBT, a multi-pass dose delivery mechanism with prototypes was developed. Dosimetric measurements for a Gd-153 radioisotope was performed to demonstrate that using multiple partially shielded Gd-153 sources for I-RSBT is feasible. A treatment planning model was developed for applying I-RSBT clinically. A custom-built, stainless steel encapsulated 150 mCi Gd-153 capsule with an outer length of 12.8 mm, outer diameter of 2.10 mm, active length of 9.98 mm, and active diameter of 1.53 mm was used. A partially shielded catheter was constructed with a 500 micron platinum shield and a 500 micron aluminum emission window, both with 180° azimuthal coverage. An acrylic phantom was constructed to measure the dose distributions from the shielded catheter in the transverse plane using Gafchromic EBT3 films. Film calibration curves were generated from 50, 70, and 100 kVp x-ray beams with NIST-traceable air kerma values to account for energy variation.
In conclusion, CBT, which is a non-invasive alternative to supplementary interstitial brachytherapy, is expected to improve dose conformity to bulky cervical tumors relative to conventional intracavitary brachytherapy. However, at the current stage, it would be time-consuming to construct a patient-specific compensator using DMLS, and the quality assurance of the compensator would be difficult. I-RSBT is a promising approach to reducing radiation dose delivered to prostate OARs. The next step in making Gd-153 based I-RSBT feasible in clinic is developing a Gd-153 source that is small enough such that the source, shield, and catheter all fit within a 16 guage needle, which has a 1.65 mm diameter.
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Gunnell, Anthony S. "Risk factors for cervical cancer development /". Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-437-2/.
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張德凱 i Dekai Zhang. "Telomerase activation in human cervical cancer". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31238038.
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Ng, Grace. "Genomic investigations of cervical cancer progression". Thesis, University of Cambridge, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.613036.
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Zhang, Dekai. "Telomerase activation in human cervical cancer /". Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B20666755.
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Fiander, Alison Nina. "Immunological responses in cervical neoplasia : immunological status of patients with cervical carcinoma and HPV-specific cytotoxic lymphocyte responses in women with cervical neoplasia". Thesis, University of Southampton, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241944.
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吳曉靑 i Xiaoqing Wu. "Post-radiotherapy cervical metastasis in nasopharyngeal carcinoma". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31222018.
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Tidy, John Anthony. "Human papillomaviruses and cervical neoplasia". Thesis, Imperial College London, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267104.
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Strander, Björn. "Cervical cancer prevention : studies on possible improvements /". Göteborg : Dept. of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Göteborg University, 2008. http://hdl.handle.net/2077/8513.
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Corden, Sally Anne. "HPV-18 DNA integration in cervical cancer". Thesis, University of Warwick, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267050.
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Yang, Wenjun. "Rotating-shield brachytherapy (RSBT) for cervical cancer". Thesis, University of Iowa, 2012. https://ir.uiowa.edu/etd/3410.
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Purpose: To assess rotating shield brachytherapy (RSBT) delivered with the electronic brachytherapy (eBT) source comparing to intracavitary (IC) and intracavitary plus supplemental interstitial brachytherapy (IC+IS BT) delivered with a conventional 192Ir radioactive source.
Method and Materials: IC, IC+IS and RSBT treamtent plan were simulated for 5 patients with bulky (>40 cc) cervical cancer. One BT plan for each patient (fraction 1) guided by magnetic resonance imaging (MRI) was used in our treatment planning system (TPS). A bio- and MRI-compatible polycarbonate (Makrolon Rx3158) intrauterine applicator was simulated for IC and RSBT, and the Vienna applicator was simulated for IC+IS BT. 192Ir was used as the radiation source of IC and IC+IS BT, and the Xoft AxxentTM eBT source was used for RSBT. A 0.5 mm thick tungsten shield was used for RSBT with different azimuthal and zenith angles, which reduced radiation transmission through the shield to less than 0.1%. The total dose delivered was calculated as the external beam radiation therapy (EBRT) dose plus the BT dose delivered over five treatment fractions.
Results: RSBT and IC+IS BT had higher dose conformity in terms of the minimum dose to the hottest 90% (D90) of the high-risk clinical target volume (HR-CTV) than IC BT for all the patients. The advantage of RSBT over IC+IS BT was dependent on the shield emission angle, tumor shape and tandem applicator location. The delivery time of RSBT was increased as finer emission angle were selected.
Conclusions: RSBT is a less-invasive potential alternative to conventional IC and IC+IS BT for treating bulky cervical cancer. RSBT delivery times are clinically acceptable if proper emission angle is selected based on the tumor shape and tandem applicator location.
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Bolger, Brendan Stephen. "Cell cycle kinetics in cervical tumours". Thesis, Imperial College London, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294984.
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Ibekwe, Chidiebere Maquincy. "Factors influencing cervical cancer screening uptake among women attending Mahalapye district hospital in Botswana-use of the health belief model". Thesis, University of Limpopo ( Medunsa Campus ), 2009. http://hdl.handle.net/10386/227.
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Thesis (MPH)--University of Limpopo, 2009.Cervical cancer is the second highest form of cancer among women in Botswana, with breast cancer being the commonest (Ferlay et al, 2002), and is currently the highest cause of cancer deaths in Botswana (Ferlay et al, 2002). Cervical cancer screening using Pap smear provides an appropriate way for early detection and prevention of cervical cancer if appropriately implemented. Cervical cancer screening was introduced in Botswana in 2003 free of charge to all women of age greater than 18 years attending government hospitals. Despite this step by the government to decrease the mortality and morbidity rates resulting from cervical cancer, the uptake of cervical cancer has remained low among women in Botswana (Botswana central statistic report, 2009). Aim of the study; The study was aimed at identifying and describing factors influencing cervical cancer screening uptake among women greater than 18 years attending Mahalapye District Hospital in Botswana using the Health Belief Model. Methodology; This study was a cross sectional survey in which a questionnaire was used to interview 300 participants in order to assess their perceived susceptibility to cervical cancer, their perceived severity of cervical cancer, their perceived benefits of doing cervical cancer screening and their perceived barriers of seeking cervical cancer screening. Descriptive statistics was used to identify and describe factors influencing cervical cancer screening uptake among women attending Mahalapye District Hospital, Botswana using the Health Belief Model construct. Each question in the questionnaire was scored using a 5-point Likert scale ranged from strongly agree (5) to disagree (1). Negatively worded questions had their scales reversed and scores for each construct of the Health Belief Model was added to get an average. Analysis compared women who had ever had „cervical cancer screening‟ with women who had never had „cervical cancer screening‟. Chi-square statistic was used to test for association of selected variables and binary logistic regression was used to measure the associations for the aggregate score of health belief model constructs. Results; Cervical cancer screening rates was 39%. Participants were aware of the perceived severity of cervical cancer (average response 2.58-3.60), perceived benefits of cervical cancer 6 screening (average response 3.10-4.33) and perceived barriers to seeking cervical cancer screening (average response 2.0-3.44) but these were not significantly associated with screening. The highest predictor of cervical cancer screening was perceived susceptibility and those with high perceived susceptibility were 3.2 times more likely to do cervical cancer screening than those with low perceived susceptibility. Main socio-demographic characteristics significantly associated with perceived susceptibility were employment, monthly income and residential area while perceived severity was significantly associated with monthly income and residential area. Conclusions; Perceived susceptibility to cervical cancer was significantly associated with cervical cancer screening. Educational programs geared towards increasing perceived susceptibility to cervical cancer can significantly improve the uptake of cervical cancer screening in Botswana as well as address issues of barriers and misconceptions associated with low uptake of cervical cancer screening.
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Evans, Mark Francis. "Molecular genetic analysis of cervical dysplasia". Thesis, University of Hertfordshire, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.338560.
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Frank, Luiza Abrahão. "Desenvolvimento de formulações nanotecnológicas contendo imiquimode para o tratamento do câncer cervical". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/179271.
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Esta tese se fundamenta na necessidade de novos tratamentos para o câncer do colo de útero visando o aumento da adesão dos pacientes aos tratamentos, assim como à qualidade de vida dos mesmos. Nesse sentido, formulações nanotecnológicas foram desenvolvidas com o objetivo de carrear o fármaco imiquimode para um local específico – a mucosa vaginal – esperando gerar melhores desempenhos nesse tratamento quando comparados com a formulação comercial. Três nanoestruturas com morfologias distintas foram propostas visando potencializar o efeito do fármaco em células de câncer cervical (SiHa). As formulações desenvolvidas compreenderam: nanoemulsões (NEimiq), nanocápsulas poliméricas (NCimiq) e nanocápsulas poliméricas revestidas com quitosana (NCimiq-chit). Observou-se que nanocápsulas poliméricas produzidas com poli(ε-caprolactona) apresentaram efeito mais pronunciado frente às células SiHa. Para tanto, essas formulações (NCimiq e NCimiq-chit) foram incorporadas em hidrogéis de quitosana e de hidroxietilcelulose a fim de possibilitar uma melhor futura aplicação para o paciente. Estudos envolvendo mucosa vaginal suína demonstraram que ambas as formulações são mucoadesivas e permeiam a mucosa vaginal. Porém, a formulação produzida com hidrogel de quitosana (NCimiq) apresentou maior desempenho. Esta foi a formulação escolhida para dar continuidade aos estudos deste trabalho, sendo objeto de estudo posterior em cultura de células SiHa a fim de elucidar o mecanismo de ação da mesma. Esses estudos demonstraram que há uma ocorrência de processos combinados de diminuição da viabilidade celular de maneira tempo-dependente e que mecanismos como apoptose, autofagia e parada de ciclo celular estão presentes. Essa formulação (NCimiq) apresentou porcentagens de morte celular significativas, mesmo utilizando baixas concentrações do fármaco. Portanto, os achados desta tese constataram que nanoestruturas modulam efetivamente a interação do fármaco com as células.This thesis deals with the need of new treatments for cervical cancer in order to increase the adherence of patients to the treatment as well as to improve their quality of life. In this sense, nanotechnological formulations were developed to carry imiquimod to a specific site – the vaginal mucosa – expecting to obtain better performance than the commercial drug in the cervical cancer treatment. Three nanostructures with different morphologies were proposed to potentilize the drug effect on cervical cancer cells (SiHa). The developed formulations are: nanoemulsions (NEimiq), polymeric nanocapsules (NCimiq) and polymeric nanocapsules coated with chitosan (NCimiq-chit). It was observed that polymeric nanocapsules produced with poly(ε-caprolactone) presented a stronger effect against SiHa cells. Therefore, formulations NCimiq and NCimiq-chit were incorporated into hydrogels of chitosan and hydroxyethylcellulose to enable a better future application on patients. The studies of this thesis involving porcine vaginal mucosa demonstrated that both formulations are mucoadhesive and that they provided a good drug permeation. However, the formulation produced with chitosan hydrogel (NCimiq) showed a better performance. This formulation was therefore chosen to follow the next steps of this work, conducted in SiHa cell culture to elucidate its action mechanism. This study demonstrated that there is an occurrence of combined processes of decreasing cell viability in a time-dependent type. The study also showed that mechanisms such as apoptosis, autophagy and cell cycle arrest are simultaneously present. The formulation NCimiq presented a significantly percentage of cellular death, even when low concentrations of the drug were used. Consequently, the findings of this thesis indicate that nanostructures effectively modulate the interaction of the drug with the cancer cells.
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Waller, Josephine. "The viral aetiology of cervical cancer : psychosocial issues". Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1446882/.
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This work stems from the discovery that certain sexually transmitted types of human papillomavirus (HPV) are the main causal agents in cervical carcinogenesis. The thesis sets out to explore the psychosocial issues that arise from linking a sexually transmitted infection with cervical cancer. Four studies were carried out. Study 1 was a survey of women attending a well-woman clinic (n=1032) and assessed awareness and knowledge about HPV. Study 2 used a population representative sample of men and women (n=1937) to assess beliefs about the risk factors for cervical cancer. Study 3 used in-depth interviews to explore the beliefs and experiences of 74 women who had taken part in HPV testing. Study 4 was a continuation of Study 3, in which 30 women were interviewed following participation in their second HPV test, a year after the first. Awareness of HPV and its link with cervical cancer was found to be low. Although there was higher awareness of sexual activity as a risk factor for cervical cancer, this was far from universal. Women testing positive for HPV who understood that it was sexually transmitted frequently reported negative emotional and social responses, different from those that have been found among women with abnormal smear test results. Leventhal's Common Sense Model of self-regulation in health and illness provided a useful framework within which to conceptualise the relationship between women's cognitive representations of HPV and their responses to the infection. It seemed that women were also engaged in the self-regulation of their relationships and were motivated to develop representations of HPV that did not impugn their current partners. Diagnosis with persistent HPV infection was associated with higher levels of anxiety about health and with the desire for immediate further investigation by colposcopy, rather than continued surveillance. The introduction of HPV testing and vaccination should be accompanied by widespread public education. If information provision is not handled in a sensitive way, it could cause confusion and stigmatise cervical cancer. More research is needed to develop ways to communicate information about HPV effectively.
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Brestovac, Brian. "Human papillomavirus and cervical cancer in Western Australia". University of Western Australia. School of Biomedical and Chemical Sciences, 2005. http://theses.library.uwa.edu.au/adt-WU2006.0037.
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Kulaga, Sophie. "Determinants of incident precursor lesions of cervical cancer". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0006/MQ44199.pdf.
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Bremer, Gerardus Leonardus. "Tumour stroma in cervical cancer, novel prognostic parameters". Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1995. http://arno.unimaas.nl/show.cgi?fid=8350.
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Siliņš, Ilvars. "Molecular epidemiology of human papillomavirus and cervical cancer /". Stockholm : [Karolinska institutets bibl.], 2001. http://diss.kib.ki.se/2001/91-7349-091-1/.
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Galbraith, Kevin. "Cervical cancer screening in Hong Kong : addressing inequity /". Thesis, Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/b39724104.
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Van, Trappen Philippe Octaaf. "Lymphangiogenesis and lymph node microdissemination in cervical cancer". Thesis, Queen Mary, University of London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.408026.
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Jha, Prabhat K. S. "Epidemiological studies of infectious agents in cervical cancer". Thesis, University of Oxford, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316863.
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Shen, Meng-Ru. "Volume-regulatory mechanisms in human cervical cancer cells". Thesis, University of Oxford, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393616.
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Wong, Tsz-lo, i 黃子璐. "Cellular role of miR-143 in cervical cancer". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48274045.
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Cervical cancer is a largely preventable malignancy due to the availability of cytology screening and vaccination against the essential initiation factor of cervical carcinogenesis, human papillomavirus (HPV). However, cervical cancer remains a significant medical burden worldwide, particularly in developing countries where large scale screening or vaccination programs are not financially feasible. Molecular tests such as HPV DNA tests have the potential to improve the speed and sensitivity of cervical cancer screening but suffer from limited specificity. Additional adjunct molecular markers are therefore desirable for enhancing molecular tests. Our previous research has revealed miR-143, a microRNA downregulated in a number of cancers, could be detected in liquid based cytology samples and is significantly reduced in cervical cancer samples and cell lines. Cellular role of miR-143 and mechanism behind its downregulation remain an unknown in cervical carcinogenesis. To explore the cellular roles of miR-143 in cervical cancer, a construct expressing miR-143 was transfected into cervical cancer cell lines HeLa, SiHa and C33A. miR- 143 overexpression was verified by qPCR. The miR-143 overexpressing cell lines were used to conduct a number of cellular function assays. It has been reported that miR-143 is able to suppress cell growth in HPV-positive HeLa. We followed up the findings and revealed miR-143 overexpression in HPV-negative C33A did not suppress cell growth in an MTT cell proliferation assay. ERK5 and KRAS, two targets of miR-143, are downregulated in colon cancer and bladder cancer to suppress cell grwoth. However, mRNA level of ERK5 and KRAS were not altered in all three miR-143 overexpressed cervical cancer cell lines, suggesting that miR-143 may not target ERK5 and KRAS transcriptionally in cervical cancer. Ability of miR-143 in regulating cell differentiation was evaluated by the expression of K10, an early keratinocyte differentiation marker. K10 was upregulated only in miR-143 overexpressed HeLa and SiHa as revealed by qPCR. A parallel increase in hSkn-1a mRNA, a transcription factor of K10, was also observed specifically in the two miR-overexpressed HPV-positive cell lines. miR-143 level is inversely correlated with cytology grading and progression of cervical disease, hinting its role in mediating cell migration and invasion during cancer progression and metastasis. A reduction of cell migration as demonstrated in wound healing assay and in vitro transwell migration assay was observed exclusively in miR-143 overexpressed HeLa and SiHa. miR-143 overexpression in C33A did not introduce any effect in cell migration. A reduction of cell invasion was also observed merely in miR-143 overexpressed HeLa and SiHa as revealed in a transwell invasion assay. Apart from studying the cellular roles of miR-143 in cervical cancer, this study has also explored mechanisms behind miR-143 downregulation in cervical cancer owing to the fact that certain miR-143 mediated cellular functions were observed only in HPV-positive cervical cancer cell lines. We hypothesized that HPV E6 and E7 oncoprotein may downregulate miR-143 in cervical cancer. The hypothesis was supported by our findings where normal cervical epithelial cell line immortalized by E6 and E7 had an undetectable level of endogenous miR-143 level. The same primary cells immortalized by shp16-hTERT expressed residual amounts of miR-143 as revealed by qPCR. Owing to the low miR-143 expression in shp16-hTERTimmortalized normal cervical epithelial cell line, downregulation of miR-143 in cervical cancer cell lines may also be contributed to hTERT overexpression and p16 silencing. Overall, miR-143 plays an important role in suppressing cell proliferation, enhancing keratinocyte differentiation marker expression, reducing migration and invasion in HPV-positive cervical cancer. Downregulation of miR-143 level may be an effect as manifested by E6 and E7 in HPV-positive cervical cancer. Differential cellular effects in miR-143 overexpressed HPV-positive and HPV-negative cervical cancer cell lines suggest that HPV oncoprotein mediates miR-143 cellular functions.published_or_final_version
Pathology
Master
Master of Medical Sciences
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Kirby, Alison Jill. "Statistical modelling for the precursors of cervical cancer". Thesis, University of Cambridge, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.303111.
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Tieche, Sarah Marie. "Somatic Acquisition of TGFBR1*6A in Cervical Cancer". The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1228313120.
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Shields, Tammy S. "Endogenous hormones and the risk of cervical cancer /". Thesis, Connect to this title online; UW restricted, 2002. http://hdl.handle.net/1773/10909.
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Nji, Anna Nkapsah. "Perceptions of Cameroonian Women Regarding Cervical Cancer Prevention". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2223.
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Women in Cameroon as well as those residing in the Maryland-Washington Metropolitan area and the Diasporas suffer a disproportionate rate of cervical cancer morbidity and mortality due to the vast disproportion in the distribution of healthcare services. The widespread human papillomavirus (HPV) vaccination holds promise for helping to attenuate the disproportion in cervical cancer screening and prevention services. Literature from other countries including Cameroon suggests that barriers to the uptake of cervical cancer screening include: culture, religion, the psychological impact of embarrassment, the influence of husbands, cost, discomfort, and vulnerability. The purpose of this study was to gain an understanding of the perceptions of the Cameroonian women regarding cervical cancer prevention, taking into consideration parental attitudes, their knowledge, and their beliefs about the acceptance and usage of the HPV vaccines and other screening services. A survey was designed from a combination of 2 separate instruments as developed, tested, and validated by Kahn et al. (2008) and Griffioen et al. (2012) for this qualitative study. The open-ended survey questions were completed by women who volunteered to participate. Data were collected between April and May, 2015. Eighty women volunteered to participate but only 30 were able to return the completed survey. Using the NVivo software version 10, data were inductively coded, analyzed, and major themes were derived. Results showed that although the women knew about HPV, the vaccines, and Pap test, there was still a need for more education. The results of this study will be provided to law makers in Cameroon to reconsider the educational needs and distribution of healthcare services for women in Cameroon.
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Wood, Brianne. "Woman-centered Cervical Screening: Identifying Women's Preferences and Factors Related to Their Preferences in Cervical Cancer Screening". Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/38748.
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Objectives
This dissertation had two overarching objectives:
1. To determine how stakeholders perceive women’s preferences for cervical
screening modalities.
2. To understand methods to measure women’s cervical screening preferences, to
inform the development and testing of a person-centered, evidence-informed approach to
preference-elicitation.
Methods
The overarching conceptual framework was the Ottawa Decision Support Framework.
The first objective was addressed by interview studies with (1) guideline developers and program
managers and (2) health professionals and women considering screening. This was
complemented by a systematic review of quantitative, qualitative and mixed-methods studies of
women’s cervical screening preferences, using the Grading of Recommendations, Assessment,
Development, and Evaluation approach to developing preference-based recommendations. This
approach was also used in a systematic review of methods to elicit women’s preferences,
addressing the second objective. These findings led to the development and field testing of a
preference-elicitation tool using International Patient Decision Aid Standards criteria, and the
development of a protocol for a population-based study of women’s preferences.
iv
Results
Objective 1
Experts disagree about whether there is enough evidence to include alternative modalities
in cervical screening programs. Women and health care professionals do not recognize that
women face a choice to participate in cervical screening. A narrative synthesis of relevant
literature presented challenges in aggregating preferences across diverse study objectives,
designs, and contexts.
Objective 2
Preference-elicitation approaches for cervical screening are heterogenous in design and
rigour. I therefore developed and field tested a tool to elicit women’s preferences, which
demonstrated that women found the tool helpful to identify their preferences. I then propose a study that uses multiple methods to apply the tool more broadly.
Conclusions
Synthesized preferences data might not be the optimal approach to incorporate preferences into cervical screening guidelines. A tool grounded in shared decision-making can help women identify their informed, values-based screening preferences.
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Wu, Xiaoqing. "Post-radiotherapy cervical metastasis in nasopharyngeal carcinoma /". Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B20843252.
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Flannelly, Grainne. "A prospective study of women with mild and moderate dyskaryosis and other studies". Thesis, University of Aberdeen, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263652.
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The management of women with mild and moderate dyskaryosis remains controversial. Any strategy must aim to be safe, efficient and cost effective. Two alternative strategies consist of immediate colposcopy for all women or a policy of cytological surveillance with colposcopy reserved for women with persistent dyskaryosis. Instead of a blanket policy for all women, selective approaches might be useful if accurate predictors of underlying high grade cervical intraepithelial neoplasia (CIN) were identified. Finally the effective treatment of women is important to prevent the development of invasive cancer. Large Loop Excision of the Transformation Zone or LLETZ is a relatively new treatment modality which has rapidly been established as the preferred treatment for women with CIN but it's efficacy has not been studied beyond a period of six months. The core of the thesis is description of a large prospective randomised study carried out in the University of Aberdeen. This was a four year project sponsored by the charity Birthright (now Well-being). Nine hundred and two women with a single smear showing mild or moderate dyskaryosis were recruited and allocated in a random fashion to either an immediate treatment group and one of three surveillance groups with periods of up to 24 months before treatment. Outcome measurements included the cytological and histological results. The cost effectiveness of two alternate management strategies for women with mild dyskaryosis is also described. The use of social factors and virological tests as secondary screening techniques is examined to determine if they might select women with high grade disease. Finally, the outcome of treatment of women including 400 women from the Birthright study using large loop excision of the transformation zone (LLETZ) is assessed.
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Palmer, Ann. "Population coverage in cervical cytology programmes". Thesis, University of Edinburgh, 1988. http://hdl.handle.net/1842/19212.
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韋霖 i William I. Wei. "Surgery for post-radiotherapy cervical metastasis in nasopharyngeal carcinoma". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1991. http://hub.hku.hk/bib/B31979543.
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黃鳳如 i Fung-yu Huang. "Molecular and cytogenetic analysis of cervical and vulvar cancer". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B26662188.
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Di, Jiangli. "A Comprehensive Assessment of the Quality of the Cervical Cancer Screening Program in Rural China". Thesis, Griffith University, 2016. http://hdl.handle.net/10072/367999.
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Cervical cancer, which is caused by sexually-acquired persistent infection with high risk human papillomavirus (HPV), continues to be a public health problem in the world, it being the second most common type of cancer among women. Nearly 87% of cervical cancer deaths occur in women living in developing countries, and China, because of its large population, carries a heavy burden of cervical cancer. Since the 1990s, there has been an increasing incidence of and mortality from cervical cancer in China, which currently accounts for 12% of new cases of cervical cancer in the world. Vaccinating girls before sexual debut and screening women for precancerous lesions can prevent cervical cancer. However, owing to the current high cost of HPV vaccinations, this is not an affordable or available option for many developing and low-income countries, including China. Moreover, the HPV vaccination is only effective for girls and young women before exposure to infection and only protects against HPV types responsible for about 70% of cervical cancer. Therefore, screening women for precancerous lesions to prevent cervical cancer remains the most important and effective strategy in less developed regions.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Griffith School of Environment
Science, Environment, Engineering and Technology
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Wolstenholme, Jane. "Counting the costs of cancer care : breast, cervical and lung cancer in Trent". Thesis, University of Nottingham, 2001. http://eprints.nottingham.ac.uk/12097/.
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The purpose of this thesis is to explore the theory, practice and application of costing with specific reference to cancer. In part it reviews the theory and guidelines related to costing methods including the recent focus on the analytical techniques used with cost data. In addition it examines how these theories and guidelines are applied in practice, by reviewing the literature on costs and cancer. The empirical research in this thesis applies costing methods to three specific cancer sites; breast, cervix and lung. This analysis provides information on the total burden of these specified cancers in terms of cost to a typical health authority (Trent). It also explores the hypothesis highlighted in previous studies that the cost of cancer increases with the stage of the disease. The final area of contribution for the thesis is in the application of recently suggested analytical techniques for cost data to the breast, cervical and lung cancer data sets; it investigates a number of proposed techniques for the analysis of skewed cost data and methods for data with incomplete patient follow up.
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Tseng, Roger Sean. "High-risk HPV: From Infection to Cervical Cancer Progression". Thesis, The University of Arizona, 2015. http://hdl.handle.net/10150/604865.
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Human papillomaviruses (HPV) are small non-enveloped viruses that infect basal cells. Most HPV infections are mild and develop warts at the site of infection. However, some high-risk serotypes of HPV are able to promote cancer formation. Serotypes 16 and 18 are responsible for the majority of cervical cancer cases [1]. Its early proteins E6 and E7 promote oncogenesis by facilitating the acquisition of 7 hallmark traits necessary for cancer: constant signaling for proliferation, insensitivity to growth suppressors, evasion of apoptosis, limitless replicative potential, angiogenesis, immune evasion, and metastasis [1, 65, 68, 72, 76, 78, 79, 81, 82, 83, 84]. In addition to E6 and E7, specific conditions of an HPV infection seem to increase cancer incidence. Among these conditions are infection at the cervix's transformation zone, HPV genome integration with host chromosomes, inflammation and the presence of estrogen [1, 60, 61, 62, 63, 64, 69, 70, 71]. Estrogen's role in cervical cancer is not well understood. It is possible that it plays a role in the transcription of oncogenes by activating ERα and subsequently activating Sp1 [65]. Specifically, the Sp1 binding site is conserved and necessary for VEGF and hTERT expression [65, 79].
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Cullimore, John Edward. "Prospects for primary and secondary prevention of cervical adenocarcinoma". Thesis, University College London (University of London), 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.261819.
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Ivansson, Emma. "Contribution of Immunogenetic Factors in Susceptibility to Cervical Cancer". Doctoral thesis, Uppsala universitet, Institutionen för genetik och patologi, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9552.
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Cervical cancer is the second most common cancer in women worldwide. Persistent infection by an oncogenic type of human papillomavirus (HPV) is a necessary but not sufficient cause and there is also a genetic component. This thesis aims to identify host genetic risk factors for cervical cancer based on the hypothesis that susceptibility is affected by genetic variation in the immune response towards HPV infection. Paper I analyzed allergy in sons and cervical cancer in their mothers, and revealed an inverse association between cervical cancer and allergy across generations. Mothers of allergic sons have a lower incidence of cervical cancer, supporting the importance of immunogenetic factors. Paper II investigated the HPV type in 1079 women diagnosed 1965-1993. All women were from families with at least two affected. It appeared that HPV 16 was becoming less common with time. There was no evidence that related women were prone to infection by the same type, indicating that the immunogenetic factors act in a general, rather than an HPV type specific, manner. Paper III and IV analysed the association of candidate genes with susceptibility to cervical cancer in 1306 women with cervical cancer in situ and 288 unrelated controls. Paper III showed the association of variation in the two immune response genes chemokine receptor 2 (CCR-2) and interleukin 4 receptor (IL-4R) with cervical cancer. In paper IV variation at several loci in the MHC region was studied and the importance of the HLA class II locus DQB1 emphasized. This thesis work supports the contribution of genes of the immune system to cervical cancer susceptibility. The genetic risk factors so far identified account for only a part of the genetic susceptibility, which implies that other yet undiscovered variants of importance remain to be identified.
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Spence, Andrea Rose. "Process of care failures in women with cervical cancer". Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=107607.
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Background: In the year 2010, approximately 1,300 incident cases of cervical cancer are predicted to have been diagnosed in Canada, making it the 3rd most common cancer among Canadian women between the ages of 20-49 years. There are reliable screening tools, diagnostic tests and effective treatments for pre-invasive lesions and early stage cancers. Thus, theoretically, invasive cervical cancer is a preventable disease. Objective: To assess the quality of health care that women with invasive cervical cancer received within 5 years prior to their diagnosis. The goal was to determine deficiencies in Pap screening and diagnostic and treatment care of pre-invasive lesions of study subjects. Methodology: A case-control study was conducted. Study subjects were long-term residents of Montreal or Laval who were diagnosed with histologically-confirmed primary cervical cancer between January 1, 1998 and December 31, 2004. The identification of cases was done by the Quebec tumour registry and by hospital medical records departments. Cervical screening, diagnostic, and pre-invasive lesion treatment histories were obtained from hospital medical charts, hospital cytology laboratories, subject (or proxy) interviews, and physician questionnaires. The main time window of observation was the interval 5 years before diagnosis but lifetime screening histories were also considered. Processes of care were assessed as per explicit medical review criteria, which were based on clinical practice guidelines and based on consensus by clinical co-investigators. The respondents of the Canadian Community Health Survey (cycle 2.1) and a matched sample of non-cervical cancer cases obtained from the Régie de l'assurance maladie du Québec were used as a comparison group for many analyses. Descriptive statistics and regression modelling techniques were performed to assess associations. Results: A total of 568 women were diagnosed with cervical cancer and met all inclusion criteria. Immigrants (OR 1.40, 95% CI 1.08-1.82), women in common-law relationships (OR 1.62, 95% CI 1.12-2.33), and women who spoke neither French nor English (OR 4.53, 95% CI 2.26-9.07) were at greatest risk of cervical cancer. The majority of cervical cancer cases (whose screening histories could be classified) were screened at least once during their lifetime (90.4%, 95% CI 87.5-93.3) and 9.6% (95% CI 6.7-12.5%) were never screened. Of those women screened in the past, 43.1% (95% CI 38.0-48.2%) were not screened within 5 years of diagnosis. It was found that the greater the time interval since the last Pap, the greater was the risk of cervical cancer. The greatest risk was found for women screened 5 or more years before diagnosis (OR 14.4, 95% CI 9.94-20.91). Cervical cytological abnormalities found by Pap testing were more likely to be appropriately managed in terms of follow-up procedures and timing compared to the follow-up of diagnosed precancerous cervical lesions. Specifically, 12.5% (95% CI 8.7-16.3) of subjects with an abnormal Pap smear and 19.4% (95% CI 13.9-24.9) of subjects with a diagnosed cervical lesion were not followed-up appropriately according to medical criteria. Similarly, 36.7% (95% CI 31.2-42.3) of subjects with an abnormal Pap smear and 52.5% (95% CI 45.5-59.4) of subjects with a cervical lesion were not managed in a timely manner. Conclusion: Most women who were diagnosed with cervical cancer were screened at least once in their lifetimes. However, many women with cervical cancer were not screened within 5 years of diagnosis. If an abnormal Pap test occurred or a precancerous lesion was diagnosed, the processes of care were found to be acceptable in most instances; however, delays in the implementation of these processes were more common. Poor follow-up of diagnosed cervical lesions was found to be more common than poor follow-up of abnormal Pap tests.Durant l'année 2010, environ 1300 cas incidents de cancer du col de l'utérus sont estimés avoir été diagnostiqués au Canada, ce qui en fait la 3e cause la plus importante de cancer chez les femmes canadiennes âgées entre 20 et 49 ans. Objectifs: Évaluer la qualité des soins de santé que les femmes atteintes de cancer invasif du col de l'utérus ont reçus dans les 5 années qui ont précédé leur diagnostic. Le but est de déterminer les faiblesses au niveau du dépistage avec le test Pap, des diagnostics et des traitements des lésions pré-invasives chez les participantes de l'étude. Méthodes: Une étude cas-témoins a été réalisée. Les participantes de l'étude étaient résidantes depuis longtemps à Montréal ou Laval et avaient reçu un diagnostic de cancer primaire du col de l'utérus (confirmé par histologie) entre le 1er janvier 1998 et le 31 décembre 2004. L'identification des cas a été faite par le registre des tumeurs du Québec et par les départements d'archives médicales d'hôpitaux. L'historique du dépistage Pap, du diagnostic et des traitements des lésions pré-invasives a été obtenu à partir de la revue des dossiers médicaux, des laboratoires de cytologie des hôpitaux, des entrevues des participantes (ou proxy) et des questionnaires relatifs aux médecins. La durée d'observation considérée à été principalement la période de 0-5 ans précédant le diagnostic, par contre, tout l'historique de dépistage à vie de la participante a aussi été considéré. Le processus des soins a été évalué selon des critères médicaux définis à partir des guides de pratiques cliniques et de consensus des co-chercheurs cliniciens. Les répondantes à l'Enquête sur la santé de la communauté canadienne (cycle 2.1) et un échantillon apparié de sujets sans cancer du col de l'utérus obtenu de la Régie de l'assurance maladie du Québec ont été utilisées comme groupe de comparaison pour plusieurs analyses. Des statistiques descriptives et des techniques de modélisation de régression ont été effectuées pour évaluer les mesures d'association. Résultats: Un total de 568 femmes ont reçu un diagnostic de cancer du col de l'utérus et respectaient les critères d'inclusion. Les immigrantes (OR 1.40, IC 95% : 1.08-1.82), les femmes vivant en union de fait (OR 1.62, IC 95% : 1.12-2.33) et les femmes ne parlant ni français ni anglais (OR 4.53, IC 95% : 2.26-9.07) avaient un plus grand risque de cancer du col de l'utérus. La majorité des cas de cancer du col de l'utérus (celles dont l'historique de dépistage pouvaient être classifié) avait eu au moins un test de dépistage au cours de leur vie (90.4%, IC 95% : 87.5-93.3) et 9.6% (IC 95% : 6.7-12.5) n'avaient jamais eu de test de dépistage. De ces femmes qui ont eu un test de dépistage au cours de leur vie, 43,1% (IC 95% : 38.0-48.2%) n'ont pas eu de dépistage au cours des 5 années précédant leur diagnostic. Le plus haut risque a été trouvé chez des femmes ayant eu un test de dépistage 5 ans et plus avant leur diagnostic (OR 14.4, IC 95% : 9.94-20.91). Spécifiquement, 12.5% (IC 95% : 8.7-16.3) des participantes avec un test Pap anormal et 19.4% (IC 95% : 13.9-24.9) des participantes diagnostiquées avec des lésions cervicales, n'avaient pas eu de suivi approprié selon les critères médicaux définis. De même, 36.7% (IC 95% : 31.2-42.3) des participantes avec un test Pap anormal et 52.5% (IC 95% : 45.5-59.4) des participantes avec des lésions cervicales n'ont pas été gérées de façon appropriée. Conclusion: La plupart des femmes qui ont reçu un diagnostic de cancer du col utérin ont eu au moins un test de dépistage au cours de leur vie. Cependant, plusieurs femmes avec un cancer du col de l'utérus n'ont pas eu de test de dépistage dans les 5 ans précédant leur diagnostic. Si un test Pap anormal survenait ou si des lésions précancéreuses étaient diagnostiquées, le processus des soins a été reconnu comme acceptable dans la plupart des cas; cependant, des délais dans la mise en œuvre de ces processus ont été fréquents.
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Baussano, Iacopo. "HPV-16 Infection and Cervical Cancer : A dynamic model". Thesis, Imperial College London, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.526378.
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Cheung, Nga-yin Annie, i 張雅賢. "Cervical cancer screening: evolution from Paptest to molecular markers". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46540465.
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Lorenzato, Felipe Rinald Barbosa. "Cervical cancer prevention and the role of human papillomavirus". Thesis, University College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268718.
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