Aim. To evaluate the diagnosis value of serum human epididymis protein 4 (HE4), cancer antigen 125 (CA125), the Risk of Ovarian Malignancy Algorithm (ROMA), and Copenhagen Index (CPH-I) at early stages for differentiating borderline ovarian tumors from epithelial ovarian cancer. Methods. We recruited 144 borderline ovarian tumors in FIGO stages I and II (BOT I+II), 108 epithelial ovarian cancers in FIGO stages I and II (EOC I+II), and 238 benign ovarian tumor patients with surgical treatment in the retrospective study. The concentration of HE4 and CA125 and the values of CPH-I and ROMA were assessed separately. Results. The HE4 level and ROMA and CPH-I values of EOC I+II were all higher than that of BOT I+II and benign groups whether in all, pre-, or postmenopausal groups (P<0.01). When distinguishing BOT I+II from EOC I+II, the AUC-ROC of CPH-I and HE4 were bigger than CA125 (P<0.001), while the CPH-I has the highest sensitivities in all and postmenopausal groups (78.7%, 85.1%), and HE4 has the highest specificity and PPV (90.91%, 88.64%) in postmenopausal groups. Under pathological stratification, HE4, ROMA, and CPH-I of the serous EOC I+II were higher than that of BOT I+II (P<0.001) and the AUC of the three indices were significantly bigger than CA125 (P<0.001). However, the concentration of HE4 and CA125 and the values of CPH-I and ROMA have no significant difference between the two endometrioid subgroups. The index with the highest sensitivity and NPV among the four indices of different pathological subtype groups was CPH-I, and the index with the highest specificities and PPV was HE4. Conclusion. CPH-I was more valuable than CA125 for differentiating BOT I+II from EOC I+II regardless of menopausal status, while HE4 might be better than CA125 for postmenopausal subgroups. HE4 and CPH-I were more favorable than CA125 for differentiating BOT I+II from EOC I+II in the case of unknown pathology or in serous type.

Objective: This study aimed to provide clinical evidence for lineage replacement and genetic changes of High-Risk Human Papillomavirus (HR-HPV) during the period of vaccine coverage and characterize those changes in eastern China. Methods: This study consisted of two stages. A total of 90,583 patients visiting the Obstetrics and Gynecology Hospital of Fudan University from March 2018 to March 2022 were included in the HPV typing analysis. Another 1076 patients who tested positive for HPV31, 33, 52, or 58 from November 2020 to August 2023 were further included for HPV sequencing. Vaccination records, especially vaccine types and the third dose administration time, medical history, and cervical cytology samples were collected. Viral DNA sequencing was then conducted, followed by phylogenetic analysis and sequence alignment. Results: The overall proportion of HPV31 and 58 infections increased by 1.23% and 0.51%, respectively, while infection by HPV33 and 52 decreased by 0.42% and 1.43%, respectively, within the four-year vaccination coverage period. The proportion of HPV31 C lineage infections showed a 22.17% increase in the vaccinated group, while that of the HPV58 A2 sublineage showed a 12.96% increase. T267A and T274N in the F-G loop of HPV31 L1 protein, L150F in the D-E loop, and T375N in the H-I loop of HPV58 L1 protein were identified as high-frequency escape-related mutations. Conclusions: Differences in epidemic lineage changes and dominant mutation accumulation may result in a proportional difference in trends of HPV infection. New epidemic lineages and high-frequency escape-related mutations should be noted during the vaccine coverage period, and regional epidemic variants should be considered during the development of next-generation vaccines.

Objective: The aim of this study was to investigate the relationship between human epididymis protein 4 (HE4) levels in seminal plasma and semen liquefaction in males. Methods: A total of 314 healthy men from the andrology department were included. The correlations between HE4 levels and prostate‐specific antigen (PSA) levels as well as conventional semen parameters (sperm density, the proportion of non‐progressively motile spermatozoa, seminal liquefaction time) were analyzed, and logistic regression was further employed to examine the association between HE4 levels and the risk of poor semen liquefaction. Results: The level of HE4 in seminal plasma was negatively correlated with semen liquefaction time (r = −0.207, p < 0.001) and positively correlated with seminal plasma PSA levels ( r = 0.280, p < 0.001), suggesting a potential link to the process of semen liquefaction. Continuous HE4 levels were standardized by dividing by 100, and participants were then categorized into quartiles (Q1–Q4) based on the standardized HE4 values. After adjusting for confounding factors, the risk of poor semen liquefaction in the Q3, Q2, and Q1 groups of the lower HE4 level was 4.024 times (95% CI: 1.908–8.485; p < 0.001), 6.320 times (95% CI: 2.818–14.175; p < 0.001), and 5.190 times (95% CI: 2.217–12.15; p < 0.001) higher, respectively, compared to the highest HE4 quartile (Q4). Conclusion: This suggests that a low level of HE4 in seminal plasma is an independent risk factor for poor semen liquefaction.