published_or_final_version / Community Medicine / Master / Master of Public Health

Grace Chung Tin Yun. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1992. / Includes bibliographical references (leaves 129-146). / SUMMARY / INTRODUCTION --- p.1 / LITERATURE REVIEW / Chapter 2.1 --- Anatomy and Histology of Uterine Cervix --- p.4 / Chapter 2.2 --- Cervical carcinoma --- p.5 / Chapter A. --- Incidence / Chapter B. --- Pathology and histological classification / Chapter C. --- Etiological factors / Chapter 2.3 --- Human Papillomavirus (HPV) --- p.12 / Chapter 2.4 --- Human papillomavirus and cervical carcinoma --- p.15 / Chapter 2.5 --- Principle of Polymerase Chain Reaction (PCR) --- p.17 / Chapter A. --- DNA structure / Chapter B. --- Repetitive DNA synthesis by PCR / Chapter 2.6 --- Basis of Restriction Fragment Length Polymorphism analysis (RFLP) --- p.18 / Chapter 2.7 --- RFLP analysis and cancer --- p.19 / Chapter 2.8 --- Oncogenes and Suppressor genes --- p.21 / Chapter A. --- Oncogenes / Chapter B. --- Tumour Suppressor Genes / Chapter 2.9 --- Multistep process of carcinogenesis --- p.24 / Chapter 2.10 --- Oncogenes and Suppressor genes in cervical carcinoma --- p.25 / Chapter A. --- Oncogenes / Chapter B. --- Tumour Suppressor Genes / MATERIALS AND METHODS / Chapter 3.1 --- Specimens --- p.41 / Chapter A. --- Cervical scrapes / Chapter B. --- Cervical tissues / Chapter C. --- Blood / Chapter 3.2 --- Extraction of Genomic DNA --- p.42 / Chapter A. --- Cervical scrapes / Chapter B. --- Tissue samples / Chapter C. --- Blood / Chapter 3.3 --- Southern blot --- p.45 / Chapter 3.4 --- Polymerase Chain Reaction (PGR) --- p.47 / Chapter 3.5 --- Nucleic Acid Probes --- p.49 / Chapter A. --- Oligonucleotide probes / Chapter B. --- Human papillomavirus / Chapter C. --- Chromosome-specific RFLP/VNTR probes / Chapter D. --- H-ras and c-myc proto-oncogenes / Chapter 3.6 --- Radioactive Labelling of Probes --- p.51 / Chapter A. --- Oligonucleotide probes / Chapter B. --- Nucleic Acid probes / Chapter C. --- Removal of unincorporated label / Chapter 3.7 --- Nucleic Acid Hybridization --- p.54 / RESULTS / Chapter 4.1 --- Optimize MgCl2 concentration for Polymerase chain reaction --- p.72 / Chapter 4.2 --- Sensitivity of Polymerase chain reaction --- p.72 / Chapter 4.3 --- Detection of HPV in cervical scrapes by PCR --- p.73 / Chapter 4.4 --- Detection of HPV in cervical scrapes using PCR with each primer-set --- p.73 / Chapter 4.5 --- Detection of HPV in cervical tissues using PCR --- p.73 / Chapter 4.6 --- Detection of HPV in cervical tissues by Southern blot hybridization --- p.74 / Chapter 4.7 --- Analysis of cervical tissues with chromosome 3-specific probes --- p.75 / Chapter 4.8 --- Analysis of cervical tissues with proto-oncogene probes H-ras and c-myc --- p.77 / Chapter 4.9 --- Analysis of cervical tissues with chromosome 17-specific probes mapped to 17pl3 --- p.77 / DISCUSSION / Chapter 5.1 --- Evaluation of methods --- p.111 / Chapter 5.2 --- Analysis of HPV using PCR --- p.114 / Chapter 5.3 --- PCR vs Southern blot hybridization in HPV detection --- p.117 / Chapter 5.4 --- HPV DNA status in cervical neoplasia and cervical cancer --- p.118 / Chapter 5.5 --- Genetic lesions in cervical neoplasia and cervical cancer --- p.119 / Chapter 5.6 --- HPV infection and genetic lesions in cervical cancer --- p.125 / CONCLUSION --- p.127 / REFERENCE --- p.129

Thesis (M. Nurs.)--University of Hong Kong, 2006.

Thesis (Ph. D.)--University of Texas at Austin, 2006. / Vita. Includes bibliographical references.

published_or_final_version / Pathology / Master / Master of Medical Sciences

Cervical cancer is the ninth leading cause of female cancer deaths in Hong Kong. In 2011, 391 new cases of cervical cancer were diagnosed and the age-standardized incidence rate was 7.2 per 100,000 standard populations. In 2012, 133 women died from this cancer, accounting for 2.5% of female cancer deaths. The age-standardized death rate of cervical cancer was 2.1 per 100,000 standard populations. Human papillomavirus (HPV) infection is an established cause of cervical cancer. HPV vaccines offer more than 70% protection for women against HPV types 16 and 18 infections and their related cervical precancerous lesions and cervical cancer. As there are usually no symptoms in high-risk HPV infection, it is often diagnosed at a late stage. Regular cervical smears can offer early detection of pathological changes and pre-cancerous stage for a timely medical treatment to prevent progression to cervical cancer. The Cervical Screening Programme (CSP) of Department of Health (DH) was launched on 8 March 2004. It is a voluntary program with the objectives to increase the population coverage of cervical screening among women and to reduce the incidence and mortality of cervical cancer in Hong Kong. Women participating in the programme are encouraged to have cervical smears in the medical centres of their own choices and to provide their cervical smear information through their health care providers to the central registry of the CSP - The Cervical Screening Information System (CSIS). As at 31 December 2013, 491,674 women have registered with CSP. When DH implemented CSP in March 2004, a report was published in the same year showing evidence that an organized screening compared with the opportunistic screening could substantially increase benefits and reduce costs. Another local study conducted early this year supported by the Health Services Research Fund also highlighted the importance and urgency in enhancing the current screening protocol. It is of public health interests to study and compare the programme outcomes with countries like Finland, Australia, UK and Japan where different policy was adopted for the prevention of cervical cancer. Information gathered from research papers on epidemiological studies has been collected and analyzed on population benefit (outcome, access, disparities), cost (cost benefit, efficiency, cost containment), equity, feasibility and constituency perspectives in formulation of the policy alternatives. In conclusion, strengthening what is already in place with better allocative efficiency could protect the female population against cervical cancer. From the education perspective, emphasis on the risk of HPV infection in the sex education curriculum would raise the awareness on the precaution of HPV infections amongst young females. Additionally, vaccination at the age of 12 can provide protection against most types of HPV. It is strongly recommended that a cervical screening and HPV co-testing strategy at a triennial interval could provide the best cost and benefit effectiveness. Together they can enhance protection coverage of women at 12 through immunization and from 25 - 64 through active population screening. The ultimate objectives to reduce incidence, mortality and increase coverage could be achieved. / published_or_final_version / Public Health / Master / Master of Public Health

This dissertation explores a diagnostic image analysis framework using multispectral digital colposcopy for real-time in vivo detection of cervical cancer. In the first part of the dissertation, the clinical feasibility of a previously developed multispectral digital colposcope (MDC) is demonstrated using a hamster cheek pouch model of carcinogenesis. Various studies on MDC applications to cervical cancer detection in human subjects are then presented. First, an automated diagnostic image analysis algorithm for cervical cancer using white light reflectance images is presented. The algorithm can identify pre-neoplastic tissue areas from an entire cervix based on intensity changes feature in the reflectance images induced by acetic acid treatment. Then, the information about tissue type is incorporated into the diagnostic image analysis framework. For this purpose, a Markov Random Field (MRF) model is adopted and the results are discussed. One of the practical difficulties of utilizing a MRF model in unpolarized white light reflectance imaging is the specular reflection problem since the effect of specular reflection extends into surrounding tissue areas. Through the use of cross polarized imaging, the effects of specular reflection reduced and the ability to segment images based on tissue types is enhanced, leading to better diagnostic performance. The diagnostic performance of polarized imaging is compared to that of unpolarized imaging. In order to assess the performance of the proposed approach, a gold standard for the entire cervical image is constructed using histopathology results from a whole cervix specimen. The results presented in this dissertation indicate that an automated diagnostic image analysis framework for early detection of cervical cancer has the potential to be clinically applied as a low cost alternative screening technique in developing countries. Advances in imaging technology as well as in image analysis algorithms will continue to reduce the cost of diagnostic imaging systems and improve the imaging and diagnostic capability, leading to an inexpensive, real-time, minimally-invasive alternative to conventional screening techniques for early detection of cervical cancer in developing countries. / text

Thesis (M. Med. Sc.)--University of Hong Kong, 2007.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Thesis (M.Nurs.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 162-174)