Factors Associated with Colposcopy-Histopathology Confirmed Cervical Intraepithelial Neoplasia among HIV-Infected Women from Rio De Janeiro, Brazil

Andrade, Angela Cristina Vasconcelos de; Luz, Paula M.; Velasque, Luciane; Veloso, Valdiléa G.; Moreira, Ronaldo I.; Russomano, Fábio Bastos; Chicarino-Coelho, Janice; Pires, Elaine; Levi, José Eduardo; Grinsztejn, Beatriz; Friedman, Ruth Khalili

doi:10.1371/journal.pone.0018297

Cited by 26 publications

(25 citation statements)

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“…A recent review of cervical cancer and HPV burden in China estimated the prevalence of high-risk HPV DNA to be 17.2% (Shi et al, 2011), a figure much lower than the 43.1% found in our population of HIV-infected women. While not as high as the 70 to 80% or higher prevalence estimates from HIV-infected women in sub-Saharan African countries with generalized HIV epidemics (e.g., Zambia (Sahasrabuddhe et al, 2007), South Africa (Denny et al, 2008) and Kenya (Luchters et al, 2010)), these rates are similar to those reported from studies reporting HPV DNA prevalence among HIV-infected women from countries with low-level or concentrated HIV epidemics like India (Sahasrabuddhe et al, 2010), Brazil (de Andrade et al, 2011), and elsewhere (Tornesello et al, 2008; Videla et al, 2009). …”

Section: Discussionsupporting

confidence: 67%

HPV Prevalence and Cervical Intraepithelial Neoplasia among HIV-infected Women in Yunnan Province, China: A Pilot Study

Zhang¹,

Tiggelaar²,

Sahasrabuddhe³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Section: Discussionsupporting

confidence: 67%

HPV Prevalence and Cervical Intraepithelial Neoplasia among HIV-infected Women in Yunnan Province, China: A Pilot Study

Zhang¹,

Tiggelaar²,

Sahasrabuddhe³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…Patients with histologically confirmed squamous intraepithelial lesion (SIL, n = 231) were enrolled consecutively from two cohorts followed at Fiocruz Clinical Care Units in Rio de Janeiro, RJ, Brazil: Fernandes Figueira Woman, Child and Adolescent National Institute (IFF, n = 182), and Evandro Chagas National Institute of Infectious Diseases (INI, n = 49). All patients received free appropriate clinical treatment [19] and provided written consent approved by the Institutional Review Board from INI and IFF/Fiocruz. HIV status was identified in all volunteers.…”

Section: Study Populationmentioning

confidence: 99%

Polymorphism in apoptotic BAX (-248G>A) gene but not in anti-apoptotic BCL2 (-938C>A) gene and its protein and mRNA expression are associated with cervical intraepithelial neoplasia

et al. 2015

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HPV is associated with cervical cancer and plays a crucial role in tumor formation. Apoptosis is regulated by different pathways involving genes that either promote (BCL2 gene) or inhibit (BAX gene) cell death. Our goal was to determine whether the BCL2-938C>A (rs2279115) and BAX-248G>A (rs4645878) single nucleotide polymorphisms (SNPs) are associated with squamous intraepithelial neoplasia (SIL) risk, and whether their phenotypic expression was impaired in these lesions. Two hundred and thirty-one cases showing SIL were classified as low SIL (LSIL, n = 101) or high SIL (HSIL, n = 130), and control subjects (n = 266) with no gynecologically proven SIL were recruited. No statistical difference in the genotype and allelic frequency of the BCL-2-938C>A polymorphism was observed among the groups. BCL2-938C/A and A/A homozygotes carriers had higher distribution of BCL-2-expressing cells in stroma in the SIL group. BCL2 mRNA-expression was not correlated with BCL2-938C>A SNPs in both groups. We did find a strong association of the BAX GG genotype and risk for SIL. No difference was observed between LSIL and HSIL groups. In BAX-248G/A and A/A homozygote carriers, the number of BAX-expressing cells was lower the epithelium area in SIL. However, mRNA expression was higher in SIL patients than in the control group. In conclusion, our data provide evidence that allele G carriers in the BAX-248G>A promoter SNP may influence the development of SIL. However, this genotype does not influence the SIL outcome. Additionally, we suggest a possible role of HPV infection in the inhibition of the expression of BAX protein, decreasing cell death, and favoring cervical carcinogenesis.

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“…5 In addition, HIV-infected women also, are frequently infected with multiple HPV types, and have a higher chance of presenting with a persistent infection or progression of these lesions to invasive cancer. 6 The conventional Pap smear is the standard screening test for cervical neoplasia in Kenya. Despite its success, the Pap smear has high false-negative rates due to poor sensitivity (51%; 95% confidence interval [CI], 0.37-0.66).…”

Section: Introductionmentioning

confidence: 99%

A comparative analysis of conventional Pap smear cytology, liquid based cytology and colposcopy clinical impression with colposcopy biopsy histology as gold standard in women undergoing colposcopy in Kenyatta National Hospital

Macharia¹,

Cheserem

et al. 2014

Int J Reprod Contracept Obstet Gynecol

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Background: Cervical cancer is one of the most common female malignancies worldwide. Since the introduction of conventional Papanicolaou smear mortality from cervical cancer has reduced considerably. Despite its success, it has sensitivity of only 51% and false negative rate of 5-10%. Approved liquid based cytology (LBC) products by FDA claim a 65-percent increased detection rate of high grade squamous intraepithelial lesions (HGSIL) compared with conventional smears, as well as decreased unsatisfactory sample rates. Evidence shows that liquid based preparation is more sensitive and accurate for the detection of both squamous and glandular lesions of the cervix. Studies of the accuracy of liquid based preparations reports sensitivity of 61-66% and specificity of 82-91%. Objective of current study is to compare the performance of conventional Pap smear cytology, liquid based cytology and colposcopy clinical impression with colposcopic biopsy as the gold standard among women eligible for colposcopy in Kenyatta National Hospital, Kenya.Methods: This was a hospital-based comparative cross-sectional study. Convenient sampling over a period of 4 months was used to recruit clients referred to colposcopy clinic with abnormal Pap smear results. Results: A total of 73 patients referred with abnormal pap smears were recruited into the study. The mean age of the patients was 38 yrs (SD ±10). About 45% of the patients interviewed did not have knowledge of Pap smear testing. Both the results of referral Pap smear and repeat Pap smear were predominantly low grade squamous intraepithelial lesions (LGSIL) or HGSIL. With biopsy results being the gold standard, Liquid based cytology had a higher specificity of 75% when compared with conventional pap smears' 11%. Conclusions: Even though colposcopy clinical impression has the highest agreement with colposcopy biopsy it's a diagnostic and not a screening test, hence Liquid based cytology showed better performance as a screening test compared to conventional Pap smear. In general, there was good agreement for cytological results of repeat CPAP and LBC. We therefore recommend that for patients referred with abnormal pap smears requiring a repeat pap smear, liquid based cytology is used due to its higher specificity compared to conventional Pap smear.

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Factors Associated with Colposcopy-Histopathology Confirmed Cervical Intraepithelial Neoplasia among HIV-Infected Women from Rio De Janeiro, Brazil

Cited by 26 publications

References 26 publications

HPV Prevalence and Cervical Intraepithelial Neoplasia among HIV-infected Women in Yunnan Province, China: A Pilot Study

HPV Prevalence and Cervical Intraepithelial Neoplasia among HIV-infected Women in Yunnan Province, China: A Pilot Study

Polymorphism in apoptotic BAX (-248G>A) gene but not in anti-apoptotic BCL2 (-938C>A) gene and its protein and mRNA expression are associated with cervical intraepithelial neoplasia

A comparative analysis of conventional Pap smear cytology, liquid based cytology and colposcopy clinical impression with colposcopy biopsy histology as gold standard in women undergoing colposcopy in Kenyatta National Hospital

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