Objective The purpose of this study was to compare the frequency of the occurrence of high-risk human papillomavirus (HPV) and abnormal anal cytology in immunocompetent women with and without HPV-induced genital lesions. Methods This analytical cross-sectional, observational study was conducted between July 2017 and December 2018 in a specialized outpatient clinic of a tertiary hospital in Fortaleza, CE. Fifty-seven immunocompetent women with and without genital intraepithelial lesions were assessed; they were divided into two groups: group 1 was comprised of women with HPV-associated genital lesions (n = 26), and group 2 was comprised of those without HPV-associated genital lesions (n = 31). Samples for liquid-based cytology and high-risk DNA-HPV polymerase chain reaction real-time tests were collected from the cervix and anus. All cases were evaluated using high-resolution anoscopy; biopsies were performed when required. The Fisher exact and chi-squared tests were applied for consolidated data in the contingency table, and the Student t-test and Mann-Whitney U-test for independent variables. Results Anal high-risk HPV infections were more frequent in group 1 (odds ratio [OR], 4.95; 95% confidence interval [CI], 1.34–18.3; p = 0.012), along with concomitant high-risk HPV infections in the uterine cervix and the anus (OR 18.8; 95% CI, 2.20–160; p < 0.001). The incidence of high-risk cervical HPV infection was associated with high-risk anal HPV infection (OR, 4.95; 95% CI, 1.34–18.3; p = 0.012). There was no statistical difference concerning abnormal anal cytology or anoscopy between the groups, and no anal intraepithelial lesion was found in either group. Conclusion Immunocompetent women with HPV-associated genital lesions and high-risk cervical HPV were more likely to have high-risk anal HPV.
Introduction:The influence of vaginal infections on the natural history of human papillomavirus (HPV) is still unclear. Objective: To determine if patients with low-grade squamous intraepithelial lesions (LSILs) and HPV have more vulvovaginitis than patients with normal liquid-based cervical cytology who were negative for HPV. Methods: This is a cross-sectional study including 322 patients who underwent cervical exams. One hundred and sixty-seven of these patients had LSILs on cervical cytology and were simultaneously hybrid capture 2 (HC2)-positive for HPV, and the remaining 155 patients were negative for malignancies and intraepithelial lesions by cytology and HC2-negative for HPV. The prevalence of vaginal infections in both groups was compared using the χ 2 test without Yates' correction. Results: Among the patients with HPV and LSILs, the most common vaginal infection was vaginosis (8.98%) compared to candidiasis (12.9%) in the patients without LSILs and HPV. No significant differences were found in the prevalence of vaginosis between the two groups (p=0.53). Candidiasis was statistically more prevalent in patients without LSILs and HPV (p<0.001). Conclusion: An association was found between the presence of Candida and the absence of HPV. Although vaginosis was more frequent among patients with LSILs and HPV, it was not statistically significant.
RESUMOIntrodução: o tratamento da lesão intraepitelial de alto grau do colo uterino (LIEAG), precursora de carcinoma invasor, é realizado preferencialmente por conização. Objetivo: correlacionar a evolução clínica de pacientes acometidas por LIEAG submetidas a conização com dados do espécime cirúrgico e com fatores epidemiológicos. Metodologia: estudo retrospectivo de 60 pacientes submetidas a conização por cirurgia de alta frequência (CAF) de 2012 a 2015, cujo acompanhamento da evolução foi realizado com exame citopatológico e colposcópico. Foram excluídas as pacientes gestantes, imunossuprimidas, que tinham se submetido apenas à biópsia, conização a frio ou histerectomia e resultados anatomopatológicos sem descrição das margens cirúrgicas. Resultados:Visando diminuir as complicações da conização, observa-se uma tendência a redução do tamanho das peças. Este estudo mostrou aumento do risco de margens comprometidas em tais situações, sem repercussão na recidiva de doença. Conclusão: a ocorrência de lesão induzida pelo HPV (Papiloma Vírus Humano). Palavras-chave:Conização. Neoplasia intraepitelial. Recidiva. ABSTRACT Introduction:The treatment of high-grade squamous intraepithelial lesion (HSIL), precursor of invasive carcinoma, is performed preferably by conization. Objective: To correlate the clinical evolution of HSIL patients submitted to conization with data from the surgical specimen and with epidemiological factors. Methodology: Retrospective study of 60 patients submitted to Loop Electrosurgical Excision Procedure (LEEP) from 2012 to 2015, whose evolution follow-up was performed with cytopathological and colposcopic exams. Pregnant, immunosuppressed, patients who had undergone biopsy, cold conization or hysterectomy, and anatomopathological results without surgical margins were excluded. Results: The height of the piece varied from 0.5 to 3.3 cm.
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