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1.
São Paulo med. j ; 142(1): e2022527, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1509214

RESUMO

ABSTRACT BACKGROUND: Managing cervical intraepithelial neoplasia grade 2 (CIN2) is challenging, considering the CIN2 regression rate, perinatal risks associated with excisional procedures, and insufficient well-established risk factors to predict progression. OBJECTIVES: To determine the ability of p16INK4a and Ki-67 staining in biopsies diagnosed with CIN2 to identify patients with higher-grade lesions (CIN3 or carcinoma). DESIGN AND SETTING: Cross-sectional study conducted at a referral center for treating uterine cervical lesions. METHODS: In 79 women, we analyzed the correlation of p16INK4a and Ki-67 expression in CIN2 biopsies with the presence of a higher-grade lesions, as determined via histopathology in surgical specimens from treated women or via two colposcopies and two cytological tests during follow-up for untreated women with at least a 6-month interval. The expression of these two biomarkers was verified by at least two independent pathologists and quantified using digital algorithms. RESULTS: Thirteen (16.8%) women with CIN2 biopsy exhibited higher-grade lesions on the surgical excision specimen or during follow-up. p16INK4a expression positively and negatively predicted the presence of higher-grade lesions in 17.19% and 86.67% patients, respectively. Ki-67 expression positively and negatively predicted the presence of higher-grade lesions in 40% and 88.24% patients, respectively. CONCLUSIONS: Negative p16INK4a and Ki67 immunohistochemical staining can assure absence of a higher-grade lesion in more than 85% of patients with CIN2 biopsies and can be used to prevent overtreatment of these patients. Positive IHC staining for p16INK4a and Ki-67 did not predict CIN3 in patients with CIN2 biopsies.

2.
Ginecol. obstet. Méx ; 92(2): 60-68, ene. 2024. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1557856

RESUMO

Resumen OBJETIVO: Determinar la prevalencia de alteraciones en la citología anal, infección anal por virus del papiloma humano y en la neoplasia intraepitelial anal; además, explorar los factores de riesgo y los serotipos asociados en pacientes con lesión intraepitelial cervical de alto grado, a partir de la hipótesis de que esta población tiene mayor riesgo de lesiones precursoras o cáncer anal. MATERIALES Y MÉTODOS: Estudio observacional, descriptivo y transversal, con componente analítico, efectuado en pacientes con diagnóstico de lesión intraepitelial cervical de alto grado (LIEAG) en dos instituciones de salud: una privada y otra pública de Bogotá, atendidas entre enero de 2017 y febrero de 2018. Se efectuó un muestreo no probabilístico, por conveniencia. RESULTADOS: Se incluyeron 119 participantes, en 4 de ellas se evidenció, en la citología anal, el hallazgo de células anormales en el tejido que reviste la parte exterior del cuello uterino. Se encontraron 14 anoscopias anormales que dieron una prevalencia de neoplasia intraepitelial anal del 6.7%. Siete eran neoplasia intraepitelial anal de bajo grado y una de alto grado. Se encontró infección por VPH anal en 45 participantes (37.8%) y se detectaron genotipos de VPH-AR en 29 participantes (24.4%). Más de 3 compañeros sexuales, más de 3 hijos y tener menos de 21 años antes del primer embarazo tuvieron un valor de p < 0.05 que confiere mayor riesgo de infección por VPH anal. CONCLUSIÓN: Es importante establecer en Colombia protocolos para la detección de la neoplasia intraepitelial anal en grupos de alto riesgo, como las pacientes con neoplasia intraepitelial cervical o cáncer de cuello uterino, e incentivar el adiestramiento en la anoscopia de alta resolución en especialistas relacionados con el diagnóstico de patología anogenital.


Abstract OBJECTIVE: To determine the prevalence of alterations in anal cytology, anal human papillomavirus infection, and anal intraepithelial neoplasia, and to explore the risk factors and associated serotypes in patients with high-grade cervical intraepithelial lesion, based on the hypothesis that this population is at higher risk for precancerous lesions or anal cancer. MATERIALS AND METHODS: Observational, descriptive, cross-sectional study, with analytical component, performed in patients diagnosed with high-grade cervical intraepithelial lesion (HG-CIL) in two health institutions: one private and one public in Bogota, visited between January 2017 and February 2018. A non-probabilistic sampling was performed, by convenience, with a sample calculated in 124 patients. RESULTS: 119 participants were included, in 4 of them it was evidenced in the anal cytology, the finding of abnormal cells in the tissue lining the outside of the cervix. Fourteen abnormal anoscopies were found, giving a prevalence of anal intraepithelial neoplasia of 6.7%. Seven were low-grade anal intraepithelial neoplasia and one was high-grade. Anal HPV infection was detected in 45 participants (37.8%) and HR-HPV genotypes were detected in 29 participants (24.4%). More than 3 sexual partners, more than 3 children and being younger than 21 years before first pregnancy had a p-value < 0.05 conferring an increased risk of anal HPV infection. CONCLUSION: It is important to establish protocols in Colombia for the detection of anal intraepithelial neoplasia in high-risk groups, such as patients with cervical intraepithelial neoplasia or cervical cancer, and to promote training in high-resolution anoscopy in specialties related to the diagnosis of anogenital pathology.

3.
Rev Med Inst Mex Seguro Soc ; 61(2): 155-162, 2023 Mar 01.
Artigo em Espanhol | MEDLINE | ID: mdl-37201194

RESUMO

Background: Cervical cancer (CaCU) is the second cancer-related cause of death for women in Mexico. Early diagnosis and monitoring of patients by cervical cytology and colposcopy are currently the preferred screening methods for identification and prevention of this disease. Objective: To describe the epidemiological panorama of cervical dysplasia diagnosed in a first-level care hospital. Methods: The study was observational, retrospective, unicentric, homodemic, transversal. Records from 6,207 women who attended the General Subzone Hospital with Familiar Medicine #8 (HGSZ/UMF 8), in Tlaxcala, Mexico were analyzed. First-time cervical cytologies were analyzed from 2019 to 2021. Results: Cervical dysplasia was found in 2.6% of the patients being the most frequent type of dysplasia NIC 1. Most of the clinical characteristics of patients with dysplasia were in agreement with those of the Mexican population. Important differences were found (comorbilities, mass index, number of sexual partners, births, positivity to changes related to HPV and vaccination) between two population sets defined by age (younger and older than 40 years). Conclusions: The only factor where a tendency to be associated to type 2 and 3 dysplasia in the population younger than 40 years was the sexually active onset of life younger than 18 years, so this possible association should be evaluated in a bigger population. Our data suggests that risks factors should be evaluated separately for these age groups due to important differences regarding their clinic and epidemiological characteristics as well as changes in risk factor exposure.


Introducción: en México, el cáncer cervicouterino (CaCU) es la segunda causa de mortalidad por cáncer en mujeres. El diagnóstico temprano y monitoreo mediante la citología cervicovaginal y la colposcopía son actualmente los métodos de tamizaje de elección para identificar y prevenir esta enfermedad. Objetivo: describir el panorama epidemiológico de displasias cervicales en un hospital de primer nivel de atención. Métodos: estudio observacional, retrospectivo, unicéntrico, homodémico, transversal. Se analizaron los expedientes de 6207 mujeres atendidas en el HGSZ/UMF No. 8, en Tlaxcala, con citologías vaginales de primera vez, durante 2019-2021. Resultados: se encontró displasia en el 2.6% de las pacientes. El tipo de displasia más frecuente fue NIC 1. Las características clínicas de las pacientes con displasia corresponden a las reportadas en población mexicana, pero se encontraron diferencias importantes (comorbilidades, IMC, NPS, gestas, positividad para cambios asociados al VPH y vacunación) entre dos tipos de población etaria (menores y mayores de 40 años). Conclusiones: el único factor donde hubo una tendencia de asociación al desarrollo de displasia tipo 2 y 3 en la población de más de 40 años fue el inicio de la vida sexual activa antes de los 18 años, por lo que se recomienda buscar una asociación en una población de mayor tamaño y evaluar factores de riesgo en los grupos etarios de manera separada por sus diferencias clínicas, epidemiológicas y factores de riesgo a los que están expuestas.


Assuntos
Infecções por Papillomavirus , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Humanos , Feminino , Gravidez , Adulto , Estudos Retrospectivos , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/epidemiologia , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Esfregaço Vaginal , Colposcopia/efeitos adversos , Programas de Rastreamento/efeitos adversos , Programas de Rastreamento/métodos , Detecção Precoce de Câncer/efeitos adversos , Detecção Precoce de Câncer/métodos , Papillomaviridae
4.
Biomedica ; 43(Sp. 3): 79-87, 2023 12 29.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38207156

RESUMO

Introduction. Cervical cancer is a relevant public health problem for low- and middleincome countries. Follow-up of positive-screened women and compliance with treatment of precancerous lesions are major challenges for these settings. Objective. To evaluate the efficacy of cryotherapy delivered by nurses for cervical intraepithelial neoplasia (CIN). Materials and methods. Direct visual inspection with acetic acid and lugol iodine (VIAVILI), and colposcopy/biopsy were performed on women 25 to 59 years old, residents of low-income areas in Bogotá, Colombia. Trained nurses offered immediate cryotherapy to every woman with positive visual inspection. Colposcopy/biopsy was performed before treatment and at a 12-month follow-up. The effectiveness was measured as cure (outcome: no-lesion) and regression (outcome: CIN1) rates of CIN2/3 using colposcopic and histological verification. Results. A group of 4.957 women with VIA/VILI was valuated. In total, 499 were screen positive and 472 accepted immediate treatment. A total of 365 women (11 CIN2/3) received cryotherapy by nurses. Cure rate was 72% (95%CI: 39%-94%) and 40% (95%CI: 22%-85%) by colposcopic and histological verification, respectively. Regression rates were 100% and 60%. There were two related non-serious adverse events. Conclusions. Cure and regression rates by colposcopic verification are like those reported for cryotherapy delivered by doctors. The sample size (CIN2/3) hinders comparisons by type of verification. Our findings support the implementation of screen-and-treat algorithms by nurses among populations with limited access to health services.


Introducción. El cáncer de cuello uterino es un problema de salud pública relevante en países de ingresos medios y bajos. El seguimiento de mujeres con tamización positiva y el acceso a tratamiento para neoplasia intraepitelial cervical (NIC) son retos mayores en estos países. Objetivo. Evaluar la efectividad de la crioterapia suministrada por enfermeras en casos de neoplasia intraepitelial de cérvix. Materiales y métodos. Se hizo la inspección visual directa con ácido acético y solución yodada (VIA-VILI), y se practicó colposcopia con biopsia, a mujeres entre los 25 y los 59 años, residentes en zonas de bajos ingresos de Bogotá. Profesionales de enfermería entrenados ofrecieron tratamiento inmediato con crioterapia a mujeres positivas en la inspección visual. Se les practicó colposcopia con biopsia antes del tratamiento y en un control a los 12 meses. Se evaluó la efectividad mediante tasas de curación (resultado: sin lesión) y regresión de NIC2/3 (resultado: ≤NIC1), por verificación colposcópica e histológica. Resultados. Se tamizaron 4.957 mujeres. En total, 499 fueron positivas y 472 aceptaron el tratamiento inmediato. Recibieron crioterapia por enfermería 365 mujeres (11 NIC2/3). La tasa de curación fue del 72 % (IC95%: 39-94 %) por verificación colposcópica, y del 40 % (IC95%: 22-85 %) por histología. Las tasas de regresión fueron del 100 y el 60 %, respectivamente. Se reportaron dos eventos adversos no graves relacionados.Conclusiones. Las tasas de curación y regresión por verificación colposcópica son similares a las reportadas con crioterapia administrada por médicos. El tamaño de la muestra con NIC2/3 dificulta la comparación por tipo de verificación. Los hallazgos apoyan la implementación de estrategias de "ver y tratar" por parte de enfermería en poblaciones con acceso limitado a servicios de salud.


Assuntos
Displasia do Colo do Útero , Neoplasias do Colo do Útero , Feminino , Humanos , Colo do Útero/patologia , Displasia do Colo do Útero/cirurgia , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapia , Neoplasias do Colo do Útero/patologia , Crioterapia , Ácido Acético
5.
Biomédica (Bogotá) ; 43(Supl. 1)2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1550070

RESUMO

Introducción. El cáncer de cuello uterino es un problema de salud pública relevante en países de ingresos medios y bajos. El seguimiento de mujeres con tamización positiva y el acceso a tratamiento para neoplasia intraepitelial cervical (NIC) son retos mayores en estos países. Objetivo. Evaluar la efectividad de la crioterapia suministrada por enfermeras en casos de neoplasia intraepitelial de cérvix. Materiales y métodos. Se hizo la inspección visual directa con ácido acético y solución yodada (VIA-VILI), y se practicó colposcopia con biopsia, a mujeres entre los 25 y los 59 años, residentes en zonas de bajos ingresos de Bogotá. Profesionales de enfermería entrenados ofrecieron tratamiento inmediato con crioterapia a mujeres positivas en la inspección visual. Se les practicó colposcopia con biopsia antes del tratamiento y en un control a los 12 meses. Se evaluó la efectividad mediante tasas de curación (resultado: sin lesión) y regresión de NIC2/3 (resultado: ≤NIC1), por verificación colposcópica e histológica. Resultados. Se tamizaron 4.957 mujeres. En total, 499 fueron positivas y 472 aceptaron el tratamiento inmediato. Recibieron crioterapia por enfermería 365 mujeres (11 NIC2/3). La tasa de curación fue del 72 % (IC95%: 39-94 %) por verificación colposcópica, y del 40 % (IC95%: 22-85 %) por histología. Las tasas de regresión fueron del 100 y el 60 %, respectivamente. Se reportaron dos eventos adversos no graves relacionados. Conclusiones. Las tasas de curación y regresión por verificación colposcópica son similares a las reportadas con crioterapia administrada por médicos. El tamaño de la muestra con NIC2/3 dificulta la comparación por tipo de verificación. Los hallazgos apoyan la implementación de estrategias de "ver y tratar" por parte de enfermería en poblaciones con acceso limitado a servicios de salud.


Introduction. Cervical cancer is a relevant public health problem for low- and middleincome countries. Follow-up of positive-screened women and compliance with treatment of precancerous lesions are major challenges for these settings. Objective. To evaluate the efficacy of cryotherapy delivered by nurses for cervical intraepithelial neoplasia (CIN). Materials and methods. Direct visual inspection with acetic acid and lugol iodine (VIA- VILI), and colposcopy/biopsy were performed on women 25 to 59 years old, residents of low-income areas in Bogotá, Colombia. Trained nurses offered immediate cryotherapy to every woman with positive visual inspection. Colposcopy/biopsy was performed before treatment and at a 12-month follow-up. The effectiveness was measured as cure (outcome: no-lesion) and regression (outcome: CIN1) rates of CIN2/3 using colposcopic and histological verification. Results. A group of 4.957 women with VIA/VILI was valuated. In total, 499 were screen positive and 472 accepted immediate treatment. A total of 365 women (11 CIN2/3) received cryotherapy by nurses. Cure rate was 72% (95%CI: 39%-94%) and 40% (95%CI: 22%- 85%) by colposcopic and histological verification, respectively. Regression rates were 100% and 60%. There were two related non-serious adverse events. Conclusions. Cure and regression rates by colposcopic verification are like those reported for cryotherapy delivered by doctors. The sample size (CIN2/3) hinders comparisons by type of verification. Our findings support the implementation of screen-and-treat algorithms by nurses among populations with limited access to health services.

6.
Cancer Manag Res ; 14: 2225-2233, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35903647

RESUMO

Purpose: Exosomes are extracellular membrane vesicles. Their content directly reflects the metabolic state of the cells from which they originate and play an important role in cellular functions and pathological states, for example, cancer. The aim was to establish the effect of exosomes from patients diagnosed with CIN1 (grade one cervical intraepithelial neoplasia) on the viability of HeLa cells in culture. It had not been documented, nor had the vesicles obtained by cervicovaginal samples taken by the patients themselves (self-taken vaginal). Patients and Methods: Exosomes were obtained from self-taken vaginal by patients diagnosed with CIN1 and healthy. The exosomes were characterized by determining the AChE (acetylcholinesterase) activity, obtaining a protein profile, and obtaining images of these by STEM. The effect on cell viability was made in HeLa and HaCaT cells in culture. Results: Vesicles between 185 nm and 415 nm were observed by STEM. Exosomes show a "protective" effect when those patients without injury are confronted with HeLa cells. On the other hand, exosomes promote viability when they come from injured patients in the presence of the same cells. Conclusion: Exosomes can be used to identify ideal biomarkers for the early diagnosis of CC (cervical cancer), follow-up of patients, and even treatment given the effects observed on cell cultures.

7.
Rev Med Inst Mex Seguro Soc ; 60(2): 164-170, 2022 Mar 01.
Artigo em Espanhol | MEDLINE | ID: mdl-35759446

RESUMO

Background: Despite the fact that the Papanicolaou technique is the most effective method of prevention and detection of cervical cancer, the precision of this tool remains controversial; Because of this, there are medical and scientific efforts to improve the quality of the procedure. Objective: Compare the quality of sampling between the conventional and modified technique. Material and methods: Descriptive and comparative observational study in 150 cervical cytology samples (75 conventional technique samples and 75 in modified technique) in women aged 25 to 64 years. Demographic variables, characteristics of the cervix and quality of the sample were analyzed. Descriptive statistics and association measures were performed. Study with risk greater than the minimum. All participants signed an informed consent. Results: The quality of the sample was satisfactory in 92.0% for the conventional technique vs 89.3% for the modified technique. The main cause of unsatisfactory samples was insufficient cellularity 6.7% in conventional technique vs 12% of the modified technique, with no significant difference between both techniques p = 0.575 (1.37; 0.45-4.1), findings that reject the working hypothesis. Conclusions: There was no significant difference when using both tests, the samples with satisfactory quality were similar between both techniques.


Introducción: a pesar de que la técnica de papanicolaou es el método más eficaz para la prevención y detección del cáncer cervicouterino, la precisión de esta herramienta sigue siendo controversial; debido a esto, existen esfuerzos médicos y científicos para mejorar la calidad del procedimiento. Objetivo: comparar la calidad en la toma de muestra entre la técnica convencional y la modificada. Material y métodos: estudio observacional descriptivo y comparativo en 150 muestras de citología cervical (75 muestras técnica convencional y 75 en técnica modificada) en mujeres de 25 a 64 años. Se analizaron variables demográficas, características del cérvix y calidad de la muestra. Se realizó estadística descriptiva y medidas de asociación. Estudio con riesgo mayor que el mínimo. Todas las participantes firmaron consentimiento informado. Resultados: la calidad de la muestra fue satisfactoria en el 92% para la técnica convencional frente al 89.3% para la técnica modificada. La causa principal de muestras insatisfactorias fue la celularidad insuficiente, la cual se presentó en el 6.7% de las muestras con técnica convencional frente al 12% de la técnica modificada, sin diferencia significativa entre ambas técnicas p = 0.575 (1.37; 0.45-4.1), hallazgos que rechazan la hipótesis de trabajo. Conclusiones: no hubo diferencia significativa al utilizar ambas pruebas, las muestras con calidad satisfactoria fueron similares entre ambas técnicas.


Assuntos
Displasia do Colo do Útero , Neoplasias do Colo do Útero , Colo do Útero , Feminino , Humanos , Teste de Papanicolaou/métodos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal/métodos , Displasia do Colo do Útero/diagnóstico
8.
Rev. Méd. Inst. Mex. Seguro Soc ; 60(2): 164-170, abr. 2022. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1367405

RESUMO

Introducción: a pesar de que la técnica de papanicolaou es el método más eficaz para la prevención y detección del cáncer cervicouterino, la precisión de esta herramienta sigue siendo controversial; debido a esto, existen esfuerzos médicos y científicos para mejorar la calidad del procedimiento. Objetivo: comparar la calidad en la toma de muestra entre la técnica convencional y la modificada. Material y métodos: estudio observacional descriptivo y comparativo en 150 muestras de citología cervical (75 muestras técnica convencional y 75 en técnica modificada) en mujeres de 25 a 64 años. Se analizaron variables emográficas, características del cérvix y calidad de la muestra. Se realizó estadística descriptiva y medidas de asociación. Estudio con riesgo mayor que el mínimo. Todas las participantes firmaron consentimiento informado. Resultados: la calidad de la muestra fue satisfactoria en el 92% para la técnica convencional frente al 89.3% para la técnica modificada. La causa principal de muestras insatisfactorias fue la celularidad insuficiente, la cual se presentó en el 6.7% de las muestras con técnica convencional frente al 12% de la técnica modificada, sin diferencia significativa entre ambas técnicas p = 0.575 (1.37; 0.45-4.1), hallazgos que rechazan la hipótesis de trabajo. Conclusiones: no hubo diferencia significativa al utilizar ambas pruebas, las muestras con calidad satisfactoria fueron similares entre ambas técnicas.


Background: Despite the fact that the Papanicolaou technique is the most effective method of prevention and detection of cervical cancer, the precision of this tool remains controversial; Because of this, there are medical and scientific efforts to improve the quality of the procedure. Objective: Compare the quality of sampling between the conventional and modified technique. Material and methods: Descriptive and comparative observational study in 150 cervical cytology samples (75 conventional technique samples and 75 in modified technique) in women aged 25 to 64 years. Demographic variables, characteristics of the cervix and quality of the sample were analyzed. Descriptive statistics and association measures were performed. Study with risk greater than the minimum. All participants signed an informed consent. Results: The quality of the sample was satisfactory in 92.0% for the conventional technique vs 89.3% for the modified technique. The main cause of unsatisfactory samples was insufficient cellularity 6.7% in conventional technique vs 12% of the modified technique, with no significant difference between both techniques p = 0.575 (1.37; 0.45-4.1), findings that reject the working hypothesis. Conclusions: There was no significant difference when using both tests, the samples with satisfactory quality were similar between both techniques.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/diagnóstico , Teste de Papanicolaou/métodos , Controle de Qualidade , Estudos Prospectivos , Medição de Risco , Solução Salina
9.
Int J Reprod Biomed ; 18(2): 129-134, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32259007

RESUMO

BACKGROUND: The role of human papillomavirus (HPV) as single or multiple infections in pregnant women would be relevant to determine the time to progression and/or the time to regression of cervical lesions. OBJECTIVE: In this preliminary study, we determined the prevalence of HPV as single or multiple infections in pregnant women from Northeastern Mexico. MATERIALS AND METHODS: Samples from 31 pregnant and 62 nonpregnant women were examined between January 2015 and November 2015 at UMAE-23 of the Instituto Mexicano del Seguro Social (IMSS). The samples of cervicovaginal exudate were obtained for HPV DNA detection using the INNO-LiPA test, and HPV infections were analyzed as single or multiple infections. Participants completed a questionnaire on sociodemographic, gynecological, obstetric, and sexual behavior characteristics. RESULTS: The mean age of the pregnant women was 25.7 ± 4.8 yr, with an average time of pregnancy of 6 ± 1 months at the time of the study. With respect to age, parity, smoking history, or oral contraceptive use no statistically significant differences between the two studied groups was observed. The HPV infection was 2.7 times higher in pregnant women (35%) than in the control group (13%). In total, 78% of the pregnant women who were HPV-positive presented with single infections compared with 28% of the nonpregnant women. CONCLUSION: A higher prevalence of HPV as a single infection was found in this sample of pregnant Mexican women. Follow-up is necessary to evaluate the persistence or regression of the infection.

10.
Oncología (Guayaquil) ; 30(1): 39-52, Abril. 2020.
Artigo em Espanhol | LILACS | ID: biblio-1140855

RESUMO

Introducción: La infección que ocasiona el Virus del Papiloma Humano (VPH), tiene alta prevalencia en mujeres sexualmente activas. Generalmente es pasajera, pero al existir algunos factores relacionados pueden llegar a desarrollar cáncer cervicouterino. Dado que la enfermedad se desarrolla con lentitud la detección en etapas tempranas ha permitido poner en evidencia la presencia del virus en las células antes que puedan transformarse y volverse tumorigénicas. El objetivo de este estudio fue establecer la prevalencia de los genotipos del Virus del Papiloma Humano en mujeres de 25 a 65 años en un grupo de pacientes de un centro oncológico en Cuenca 2017 ­2018. Métodos:Es un estudio descriptivo, retrospectivo, analítico, en el cual se recopiló información de las historias clínicas y registros físicos del Laboratorio de Biología Molecular y del sistema médico de SOLCA -Cuenca, SOFTCASE, para establecer la prevalencia de VPH durante el periodo 2017 -2018.Se utiliza ODDS Ratio para demostrar asociación entre las variables demográficas y los grupos de serología de VPH de riesgo alto versus VPH De riesgo bajo. Resultados:Se incluyeron 594casos, con edad entre36 y 40 años n=103/594 (17.3%). De estado civil casadas n=318/594 (53.5%). Con paridad igual a 2 n=159/594 (26.8%). Casospositivos de VPH fueron 424/594 (71.38%) IC95% (71.23% a 71.53%), Genotipos de alto riesgo con el 58.01%, genotipos de probable bajo riesgo con el 33.25% y genotipos de bajo riesgo 8.72%. La prevalencia del 50% de la población positiva según el genotipo lo explicalos VPH 16, 71, 58, 6 y 31. De este grupo los VPH con serología 16, 58 y 31 tienen un riesgo Alto de malignidad. No se reportó asociación entre los VPH de alto riesgo con alguna de las variables demográficas. Conclusión:El grupo etario con mayor número de casos positivos perteneció a las mujeres de entre 36 y 40 años de edad, con paridad igual a 2 y de estado civil casadas. El subtipo VPH-16 fue el genotipo más prevalente del grupo de alto riesgo de malignidad. El subtipo VPH-71 fue el segundo genotipo más prevalente con un perfil de probable bajo riesgo de malignidad.


AbstractIntroduction:The infection caused by the Human Papilloma Virus (HPV) has a high prevalence in sexually active women. It is generally temporary, but when there are some related factors, they can develop cervical cancer. Since the disease develops slowly, detection in early stages has made it possible to reveal the presence of the virus in cells before they can transform and become tumorigenic. The objective of this study was to establish the prevalence of Human Papilloma Virus genotypes in women aged 25 to 65 years in a group of patients from an oncology center in Cuenca 2017-2018. Methods: It is a descriptive, retrospective, analytical study, in which information was collected from the medical records and physical records of the Molecular Biology Laboratory and the SOLCA -Cuenca medical system, SOFTCASE, to establish the prevalence of HPV during the period 2017 -2018. ODDS Ratio is used to demonstrate association between demographic variables and high-risk HPV versus low-risk HPV serology groups. Results: 594 cases were included, aged between 36 and 40 years, n = 103/594 (17.3%). Marital status married n = 318/594 (53.5%). With parity equal to 2 n = 159/594 (26.8%). Positive HPV cases were 424/594 (71.38%) 95% CI (71.23% to 71.53%), high risk genotypes with 58.01%, probable low risk genotypes with 33.25% and low risk genotypes 8.72%. The prevalence of 50% of the positive population according to genotype is explained by HPV 16, 71, 58, 6 and 31. Of this group, HPV with serology 16, 58 and 31 have a high risk of malignancy. No association was reported between high-risk HPV with any of the demographic variables. Conclusion: The age group with the highest number of positive cases belonged to women between 36 and 40 years of age, with parity equal to 2 and married marital status. The HPV-16 subtype was the most prevalent genotype in the group at high risk of malignancy. The HPV-71 subtype was the second most prevalent genotype with a profile of probable low risk of malignancy.


Assuntos
Humanos , Infecções por Papillomavirus , Papillomavirus Humano 16 , Genótipo , Displasia do Colo do Útero , Reação em Cadeia da Polimerase
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