Objectives: to determine the incidence of the main high oncogenic risk types of the human papillomavirus (HPV) ( 16, 18, 31 and 33) and the risk factors for cervical adenocarcinoma. Methods: a case-control study was carried out with 324 women (69 with adenocarcinoma and 260 healthy controls) between 2001 and 2014. Information on risk factors associated with adenocarcinomawere collected and the detection performed on HPVby using Polymerase Chain Reaction (PCR) method. Results: adenocarcinoma was associated with age ≥40 years old (OR=2.95; 95%CI=1.13-7.71), ≤3 years of schooling (OR=2.34; 95%CI=1.02-5.37), presence of HPV (OR=6.75; 95%CI=2.41-18.91),women in menopausal status (OR=4.76; 95%CI:1.70-13.31) black race (OR=6.71; 95%CI= 2.11-21.32) and never had undergone cervical cancer screening (OR=9.92; 95%CI:2.41-40.81). Andamong the HPV types detected, HPV 18 was observed to be strongly associated with adenocarcinoma of the cervix (OR=99.1; 95%CI=12.96-757.78). Conclusions: the factors associated with cervical adenocarcinoma were ≥40 years old, ≤3 years of schooling, black race, menopausal status, never had undergone cervical cancer screening and the presence of HPV.
Cytokines have an important role in the progression of cervical lesions and/or adenocarcinoma. We investigated whether polymorphisms at the promoter regions of the IL-10 -1082 (A> G, rs1800896) and TNF-α -308 (G>A, rs1800629) genes were associated with susceptibility to progression of cervical dysplasia and adenocarcinoma. The study consisted of 240 women infected with HPV (72 with adenocarcinoma and 168 with cervical intraepithelial lesions), and 169 healthy control women. There was a significant increase in the frequency of the IL10 -1082G allele in both cervical dysplasia (OR = 1.39; P = 0.0372) and adenocarcinoma patients (OR = 2.19; P = 0.0002). For the TNF-α -308 polymorphism, there was higher susceptibility to cervical lesions, in relation to risk factors such as: age > 35 years old (OR = 2.57; p = 0.0057), age of first sexual intercourse 1st < 18 years old (OR = 6.6224, p < 0.0001), smoking (OR = 3.80; P = 0.0003), African ancestry (OR=5.18, p < 0.0001) and co-infection with Chlamydia trachomatis (OR=2.41, p=0.0315). Our findings suggest that polymorphisms in the IL-10 and TNF-α genes may play a role in the susceptibility or severity of cervical disease in the study population. Keywords: Tumor Necrosis Factor-alpha; Interleukin 10; Cervical lesions; Adenocarcinoma; HPV.
Objetivo: determinar a frequência da persistência do HPV em mulheres tratadas para o adenocarcinoma cervical. Método: trata-se de um estudo quantitativo, descritivo, retrospectivo, do tipo coorte, com 77 mulheres genotipadas para o HPV antes do tratamento e com adenocarcinoma cervical. Coletou-se novo material de secreção cervical após o tratamento para a realização da detecção do DNA do HPV por reação de cadeia da polimerase. Utilizou-se o programa estatístico Epi Info 7.1.4. para a análise dos dados. Resultados: observou-se que, das 77 pacientes, foi possível determinar a genotipagem do HPV após o tratamento em 30 mulheres e, destas, 7 (23,3%) apresentaram o HPV detectável. Encontraram-se os tipos de HPV dos quais quatro pacientes (57,1%) estavam com o HPV 31, sendo que, em uma paciente, estava associado ao HPV 18; o 33 em duas mulheres (28,6%), sendo que em uma estava associado ao HPV 16 e uma apresentou os HPV 11 e 56 associados (14,2%). Conclusão: detectou-se o HPV na secreção cervical em 23,3% das mulheres após o tratamento para o adenocarcinoma de colo uterino, sendo o HPV 31 o tipo mais frequente. Descritores: Adenocarcinoma; HPV; Falha de Tratamento; Prevalência; Colo do Útero; Doenças Sexualmente Transmissíveis. AbstractObjective: to determine the frequency of persistence of HPV in women treated for cervical adenocarcinoma. Method: this is a quantitative, descriptive, retrospective, cohort study, with 77 women genotyped for HPV before treatment and with cervical adenocarcinoma. New cervical secretion material was collected after treatment to detect HPV DNA by polymerase chain reaction. The Epi Info 7.1.4 statistical program was used for data analysis. Results: it was observed that, out of 77 patients, it was possible to determine HPV genotyping after treatment in 30 women, and of these, seven (23.3%) had detectable HPV. HPV types were found, of which four patients (57.1%) had HPV 31, and in one patient it was associated with HPV 18; o 33 in two women (28.6%), one of whom was associated with HPV 16 and one had HPV 11 and 56 associated (14.2%). Conclusion: HPV was detected in cervical secretion in 23.3% of women after treatment for cervical adenocarcinoma, with HPV 31 being the most frequent type. Descriptors: Adenocarcinoma; Papillomaviridae; Treatment Failure; Prevalence; Cervix Uteri; Sexually Transmitted Diseases.ResumenObjetivo: determinar la frecuencia de persistencia del VPH en mujeres tratadas por adenocarcinoma cervical. Método: estudio de cohorte cuantitativo, descriptivo, retrospectivo, con 77 mujeres genotipadas para el VPH antes del tratamiento y con adenocarcinoma cervical. Se recogió nuevo material de secreción cervical después del tratamiento para detectar el ADN del VPH por reacción en cadena de la polimerasa. Se utilizó el programa estadístico Epi Info 7.1.4. para el análisis de datos. Resultados: se observó que, de las 77 pacientes, fue posible determinar el genotipo del VPH después del tratamiento en 30 mujeres, y de estos, 7 (23.3%) tenían VPH detectable. Se encontraron tipos de VPH, de los cuales cuatro pacientes (57.1%) tenían VPH 31, y en una paciente se asoció con VPH 18; o 33 en dos mujeres (28,6%), una de las cuales estaba asociada con el VPH 16 y una tenía VPH 11 y 56 (14,2%). Conclusión: el VPH se detectó en la secreción cervical en el 23,3% de las mujeres después del tratamiento para el adenocarcinoma de cuello uterino, siendo el VPH 31 el tipo más frecuente. Descriptores: Adenocarcinoma; Papillomaviridae; Insuficiencia del Tratamiento; Prevalencia; Cuello del Útero; Enfermedades de Transmisión Sexual.
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