We analyzed 87 cervical samples from Campo Grande, Mato Grosso do Sul, with a PGMY/GP+ nested PCR system. Positive samples were typed using E7 type-specific primer pairs for HPV 6/11, 16, 18, 45 and 66. Eighteen samples (22%) were infected with HPV6/11, 18 samples (22%) with HPV66, 13 samples (15.9%) with HPV45, 8 samples (9.8%) with HPV18 and 7 samples (8.5%) with HPV16. Seventeen samples (20.7%) were infected by two HPV types, and five samples (6.1%) by three HPV types. We conclude that infection with multiple types is present at a high frequency in our population and that there is a relation between some types and cytological finds.
RESUMOIntrodução: A resposta imune pode ser um elemento chave para a progressão ou remissão da infecção pelo papilomavírus humano (HPV) no estroma da cérvice uterina. Este estudo objetivou quantificar no estroma cervical a presença de linfócitos T CD4, CD8 e células NK, por imunohistoquímica, em lesões de alto e baixo grau em pacientes infectadas por HPV. Métodos: Utilizou-se 56 amostras de biópsia da estroma cervical, sendo 43 amostras positivas para DNA de HPV de alto risco oncogênico e com diagnóstico histopatológico de neoplasia intraepitelial cervical (NIC) de alto e baixo grau, ou negativa para lesão intraepitelial e malignidade (NILM), e 13 amostras de pacientes negativas para DNA de HPV com diagnóstico histopatológico NILM. Resultados: Maior quantidade de linfócitos T CD4 foi observada em amostras NIC II/III, carcinoma e NILM (p=0,04) e naquelas cuja carga viral esteve entre 10 e 1,000 RLU/PCB. O predomínio de linfócitos T CD8 ocorreu em maior proporção nas amostras NIC II/III (p=0,02) e em amostras com carga viral entre 100 e 1.000 RLU/PCB. As células NK prevaleceram nas amostras com lesões de baixo grau e com baixa carga viral. Conclusões: Este estudo comprovou que nas fases iniciais da infecção, onde não há ainda alterações celulares de alto grau, não temos a presença de células que possam desencadear a fase efetora da resposta imune. Palavras-chaves: Papilomavírus humano. Resposta imunológica. Imunohistoquímica. ABSTRACT Introduction:Immune response might be a key element regarding the progression or regression of human papillomavirus (HPV) infection in the stroma of the uterine cervix. This study aimed to quantify the presence of CD4 and CD8 T lymphocytes and NK cells in the cervical stroma, by means of immunohistochemistry, in high and low grade lesions in patients infected by HPV. Methods: Fifty-six biopsy samples from the uterine cervix were used. Fortythree samples were positive for oncogenic high-risk HPV DNA and had a histopathological diagnosis of high and low-grade cervical intraepithelial neoplasia (CIN) or negative for intraepithelial lesion and malignancy (NILM); while the other 13 samples were negative for HPV DNA with a histopathological diagnosis of NILM. Results: Higher quantities of CD4 T lymphocytes were observed in CIN II/III, carcinoma and NILM samples (p = 0.04) and in those in which the viral load was between 10 and 1.000 RLU/PCB. CD8 T lymphocytes were predominant in CIN II/III samples (p = 0.02) and also in samples with viral loads between 100 and 1,000 RLU/PCB. NK cells predominated in samples with low-grade lesions and low viral load. Conclusions: This study proved that in the initial stages of the infection, in which no high-grade cell abnormalities have yet occurred, no cells that might trigger the effector phase of the immune response.
J Bras Patol Med Lab • v. 42 • n. 6 • p. 449-453 • dezembro 2006 key words unitermos abstract Objective: To compare the relation between HPV viral load by hybrid capture II test (HCII) and cytological findings. Methods: Three hundred sixty-two reagent samples to HPV DNA by HCII had their viral loads classified in four categories and correlated to cytological results. Results: Twenty-two samples (6.1%) were reagent only to low-risk oncogenic types (group A) and 340 (93.9%) were reagent to high-risk oncogenic types (group B). The correlation between viral load for the reagent samples to group A and cytological results showed low-grade squamous intraepithelial lesion (LSIL) predominance (50%). Most of this group samples had viral load between 1 to <10RLU/PCA. Of the patients that were reagent to group B 52.1% had LSIL cytology and 38.2% were negative to intraepithelial lesion and malignancy (NILM) cytology. The patients with LSIL had viral load well distributed with a slight predominance of 100 to < 1,000RLU/PCB category. The samples had viral load between 1 to <10RLU/PCB showed NILM cytology predominance (48.1%). High-grade squamous intraepithelial lesions (3.4%) were present on the samples with viral load between 100 to <1,000RLU/PCB (p = 0.023). There was a correlation between the median for group B viral load and LSIL/HSIL results. Conclusions: The quantification of viral load, mainly of high-risk HPV types, may be a useful tool for dealing with patients who have suspicious lesions. Human papillomavirus Viral load Cytology resumo Objetivo: Comparar a relação entre a carga viral do HPV por captura híbrida II (HCII) e os achados citológicos. Metodos: Trezentas e sessenta e duas amostras reagentes para DNA de HPV por HCII tiveram suas cargas virais classificadas em quatro categorias e correlacionadas aos resultados citológicos. Resultados: Vinte e duas amostras (6,1%) foram reagentes somente para os tipos de baixo risco oncogênico (grupo A) e 340 (93,9%) foram reagentes para os tipos de alto risco oncogênico (grupo B). A correlação entre carga viral das amostras reagentes para o grupo A e resultados citológicos mostrou predominância (50%) de lesão escamosa intraepitelial de baixo grau (LSIL
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