Recurrence rate of CIN in HIV-positive women was higher than in HIV-negative women. The factors associated with recurrence were HIV infection, glandular involvement, and positive margins.

The authors report one case of late cutaneous Schistosomiasis mansoni in a biopsy of a skin lesion in the sacral region in a 51-year-old female living in Contagem, Minas Gerais. The patient was treated successfully with oxamniquine (Mansil®).

ObjectiveThis study focused on comparing the expression levels of p16, Ki-67, and minichromosome maintenance 7 (MCM7) protein in normal and affected cervical epithelium to ascertain the biological significance of these markers in detecting progressive cervical disease.MethodsA quantitative and based on-scanning-microscopy analysis of the three markers expression was performed in normal and cervical intraepithelial neoplasia (CIN) I, II, and III tissues. p16 area as well as p16, Ki-67, and MCM7 positive cells or nuclei were evaluated according to their distribution and extent through the cervical epithelium.ResultsA clear p16 over-expression was observed in all the dysplastic epithelium tissue samples. The quantitative analysis of p16 area as well as the number of p16 positive cells was able to better discriminate the CIN lesions grades than the usual semi-quantitative analysis. The average Ki-67 labeling indexes for the normal epithelium, CIN I, CIN II, and CIN III groups were 19.8%, 27.3%, 32.8%, and 37.1%, respectively, whereas the mean MCM7 labeling indexes for the correspondent grades were 27.0%, 30.4%, 50.5%, and 67.2%. The Ki-67 and MCM7 labeling indexes were closely correlated with the CIN histological grade, with higher labeling indexe values obtained from the more severe lesions (p<0.05), being the MCM7 labeling indexes the highest values in all the CIN categories (p<0.05).ConclusionWe observed a good correlation among the p16, Ki-67, and MCM7 data. In addition, MCM7 demonstrated to be a more efficient and sensitive marker to assess disease progression in the uterine cervix.

Background: Cervical cancer has high prevalence and mortality rates in worldwide female population. Persistent infection by high-risk Human Papillomavirus (hr-HPV) is the main cause of this cancer. However, many environmental, genetical, and epigenetical cofactors can modulate viral infection and cervical carcinogenesis. Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism is a genetic factor that has been associated with many pathologies, including cancer. Nevertheless, studies with cervical cancer presented controversial results, and varied according to ethnicity. Thus, the aim of this study was to determine association between MTHFR C677T polymorphism, Human Papillomavirus (HPV) infection and cervical cancer. Methods: A case-control study was performed with 150 histological cervical samples. Case group were divided in Cervical Intraepithelial Neoplasia (CIN) grade I (n = 30), CIN II (n = 30), CIN III (n = 30), and Squamous Cervical Carcinoma (SCC) (n = 30). Control group was composed by 30 samples without lesion, presenting cervicitis. HPV detection was performed by conventional Polymerase Chain Reaction (PCR) with SPF primers set, and by real-time PCR specific for HPV 16 and hr-HPV. MTHFR C677T polymorphism was analyzed by PCR followed by Restriction Fragment Length Polymorphism (RFLP). Results: Frequency of MTHFR CC genotype was 72.7% (n = 109), CT 23.3% (n = 35) and TT 4.0% (n = 6). Polymorphic T allele frequency was 15.7%. No statistically significant association was observed between MTHFR C677T polymorphism and presence of pre-neoplastic or neoplastic cervical lesions. Similar frequencies of T allele was observed in control (23.3%) and cases (13.3%) groups (p = 0.174). In addition, there was no statistically significant association between MTHFR C677T polymorphism and viral infection, even considering hr-HPV or HPV 16 positivity. Conclusion: MTHFR C677T polymorphism was not associated with cervical cancer and HPV infection.

Fatores de risco de recidiva de lesões intra-epiteliais cervicais após conização por cirurgia de alta freqüência em mulheres portadoras e não portadoras do vírus da imunodefi ciência humanaRisk factors for cervical intraepithelial lesions after loop electrosurgical excision procedure in HIV-infected and non-infected women Objetivos: avaliar os fatores de risco associados à recidiva das lesões intra-epiteliais, após conização do colo com cirurgia de alta freqüência. Métodos: estudo caso-controle aninhado em coorte de 201 pacientes que se submeteram à conização com cirurgia de alta freqüência por apresentarem lesão intra-epitelial cervical, acompanhadas, em média, por dois anos. Participaram 94 portadoras do HIV e 107 não-portadoras do vírus. A conização cervical foi realizada por cirurgia de alta freqüência e a peça cirúrgica encaminhada para exame histopatológico, que avaliou o grau da lesão, as margens e a ocupação glandular. Após a cirurgia, as pacientes foram examinadas a cada seis meses com citologia oncótica e colposcopia. Foram consideradas recidivas as lesões que, após a cirurgia, foram confi rmadas novamente por biópsia. Neste estudo, foram considerados casos as pacientes com recidiva e controles as sem recidiva. As comparações entre os grupos foram realizadas pelo teste do χ 2 e a análise multivariada pela regressão logística. Para a análise de sobrevida foi utilizado o método de Kaplan-Meier (teste log-rank). Resultados: houve recidiva das lesões em 40 pacientes. As variáveis que inicialmente apresentaram signifi cância estatística foram: número de parceiros, soropositividade, margens do cone e envolvimento glandular, como indicadores do risco para recidiva. A ocorrência simultânea de ocupação glandular e margens comprometidas apresentou as recidivas mais freqüentes. Após análise pela regressão logística, permaneceram signifi cativamente associados à recorrência das lesões: ocupação glandular (OR=9,1; IC a 95%:13,0-27,5); presença do HIV (OR=4,6; IC a 95%:1,1-6,3); margens comprometidas (OR-2,6; IC a 95%:1,9-11,2). Conclusões: os fatores de risco associados à recidiva das lesões intra-epiteliais cervicais foram: soropositividade, ocupação glandular e margens comprometidas. PALAVRAS-CHAVE:Neoplasia intra-epitelial cervical; Conização; Infecções por HIV; Recidiva local de neoplasia; Displasia do colo do útero Abstract Purpose: to evaluate risk factors associated with cervical intraepithelial lesion recurrence after LEEP conization. Methods: nested case-control study in a cohort of 201 patients with cervical intraepithelial lesion, that were submitted to LEEP conization. Average follow-up of these patients was 2 years. Ninety-four HIV-infected women and 107 non-infected were enrolled. Cervical conization was achieved by the Loop Electrosurgical Excision Procedure (LEEP). Evaluated surgical biopsy histopathological characteristics were lesion grade, lesion borders and glandular involvement. After surgery all patients were submitted to a colposcopy and cytological evaluation every six months. Recurrent lesi...