Chlamydia trachomatis and human papillomavirus coinfection: association with p16INK4a and Ki67 expression in biopsies of patients with pre-neoplastic and neoplastic lesions

Abstract

The objective of this study was to identify the frequency of coinfection by human papillomavirus (HPV) and Chlamydia trachomatis (CT) in cervical lesions and relate it with immunohistochemical expression of p16INK4a and Ki67, both oncogenicity markers. A cross-sectional study with 86 women from primary care units in southern Brazil was conducted. Cervical swabs were collected for HPV-DNA and CT-DNA detection, through the polymerase chain reaction technique (PCR). The immunohistochemical analysis was performed on biopsy cervical tissue material to identify the expression of p16INK4a and Ki67 cell cycle markers. About 83 % were positive for HPV-DNA and 19% had coinfection with CT-DNA. Among coinfected women, 56% expressed p16INK4a. There was a statistically significant association between the histological grade of the lesion and Ki67 expression. All high-grade lesions, 50% of low-grade lesions and 31% of negative biopsies expressed Ki67 (p = 0.004). A total of 37% of coinfected women expressed both markers. In conclusion, although more than half of the coinfected patients have expressed p16INK4a and more than one third have expressed both markers, these results suggest no association between those variables. However, other studies involving larger samples are necessary to corroborate such findings.

Molecular Detection of HPV and Chlamydia trachomatis Infections in Brazilian Women with Abnormal Cervical Cytology

“…Other similar studies have shown that Ct infection was not associated with CC, because the prevalence of bacteria is very low in this cancer. 10,11 However, a positive or negative association between HPV, Ct, and CC has been found in studies comparing results obtained by different methodologies, such as serological status for Ct and HPV, presence of one or another agent by highly sensitive molecular techniques, and others by serological status. [10][11][12] Because of these methodological differences, it is difficult to compare results from different studies, and caution is needed in interpreting the possible existence of any linkage between Ct and cervical carcinogenesis.…”

Lack of Significant Effects of Chlamydia trachomatis Infection on Cervical Cancer Risk in a Nested Case-Control Study in North-East Thailand

“…Furthermore, links with other markers of increasing malignancy like p16INK4a (Calil et al, 2011) and effects on host DNA damage and proliferation as well as DNA damage responses (Chumduri et al, 2013) could not be addressed in the present work. Future studies should take these possibilities into consideration to allow a more comprehensive picture of the influence of C. trachomatis infection on cervical cancer development in Thailand to be obtained.…”

Prevalência e Riscos de Infecção Genital Feminina por Chlamydia Trachomatis: Revisão Sistemática

“…Hipotetiza-se que a CT também predispõe a gravidez ectópica por alteração da expressão FTPROKR, e que é maior em mulher com infecção passada por CT 19 . Outros fatores de risco são identificados pelos autores, tais como, flora vaginal anormal 21 , presença de condiloma acuminado, inflamação discreta, instrumentação do útero, tipo de atividade facilitadora (por exemplo, entre profissionais do sexo), consumo de álcool, uso de algodão ou absorvente, uso de substâncias ou produtos de higiene vaginal para o sexo [22][23] . Dentre os 174 artigos selecionados para a revisão, 56 mencionaram a prevalência obtida.…”