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Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):540-546
To determine the frequency of sexually transmitted infections (STIs) in asymptomatic women and the association of STIs with cervical intraepithelial neoplasia (CIN).
A cross-sectional studywas performed, enrollingwomen examined in a general gynecology clinic and in a colposcopy referral center fromOctober 2014 to October 2015. The colposcopy groupconsisted of 71women, and the general gynecologygroupconsisted of 55 women. Cervical samples were collected for cervical cytology and a multiplex realtime polymerase chain reaction (PCR) was developed to detect human papillomavirus (HPV) and the STIs caused by the following microorganisms: Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, and Neisseria gonorrhoeae. A multivariate analysis was performed by logistic regression, considering the significance level of 0.05.
The general frequency of STIs was: 46.8% (HPV); 27.8% (C. trachomatis); 28.6% (M. genitalium); 0.8% (M. hominis); 4.8% (U. urealyticum); and 4.8% (N. gonorrhoeae). The significant risk factors for CIN were: HPV infection (odds ratio [OR] = 2.53; p = 0.024); C. trachomatis (OR = 3.04; p = 0.009); M. genitalium (OR = 2.37; p = 0.04); and HPV and C. trachomatis coinfection (OR = 3.11; p = 0.023). After the multivariate analysis, a significant associationwas found betweenHPVand CIN(OR = 2.48; 95% confidence interval [95%CI]: 1.04-5.92; p = 0.04); and between C. trachomatis and CIN (OR = 2.69; 95%CI: 1.11-6.53; p = 0.028).
The frequency of STIs was high in asymptomatic patients. Infections by HPV and C. trachomatis were independently associated with the presence of CIN. The high frequency of STIs in asymptomatic women suggests the need for routine screening of these infections.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):540-546
To determine the frequency of sexually transmitted infections (STIs) in asymptomatic women and the association of STIs with cervical intraepithelial neoplasia (CIN).
A cross-sectional studywas performed, enrollingwomen examined in a general gynecology clinic and in a colposcopy referral center fromOctober 2014 to October 2015. The colposcopy groupconsisted of 71women, and the general gynecologygroupconsisted of 55 women. Cervical samples were collected for cervical cytology and a multiplex realtime polymerase chain reaction (PCR) was developed to detect human papillomavirus (HPV) and the STIs caused by the following microorganisms: Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, and Neisseria gonorrhoeae. A multivariate analysis was performed by logistic regression, considering the significance level of 0.05.
The general frequency of STIs was: 46.8% (HPV); 27.8% (C. trachomatis); 28.6% (M. genitalium); 0.8% (M. hominis); 4.8% (U. urealyticum); and 4.8% (N. gonorrhoeae). The significant risk factors for CIN were: HPV infection (odds ratio [OR] = 2.53; p = 0.024); C. trachomatis (OR = 3.04; p = 0.009); M. genitalium (OR = 2.37; p = 0.04); and HPV and C. trachomatis coinfection (OR = 3.11; p = 0.023). After the multivariate analysis, a significant associationwas found betweenHPVand CIN(OR = 2.48; 95% confidence interval [95%CI]: 1.04-5.92; p = 0.04); and between C. trachomatis and CIN (OR = 2.69; 95%CI: 1.11-6.53; p = 0.028).
The frequency of STIs was high in asymptomatic patients. Infections by HPV and C. trachomatis were independently associated with the presence of CIN. The high frequency of STIs in asymptomatic women suggests the need for routine screening of these infections.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(6):288-293
To evaluate the expressions of biomarkers p16 and Ki-67 in low-grade (LG) or high-grade (HG) lesions, and to relate them to risk factors and the recurrence of these lesions.
A retrospective case-control study of 86 patients with LG and HG lesions who underwent a loop electrosurgical excision procedure (LEEP) between 1999 and 2004. The control group was composed of 69 women with no recurrence, and the study group, of 17 patients with recurrence. All patients were followed-up over a two-year period after surgery, and screened every six months, including cytology and colposcopy. Biopsy samples collected from LEEP were submitted to immunohistochemical analysis for p16 and Ki-67. The statistical analysis was performed using the Statistical Package for the Social Sciences software (SPSS, IBM-SPSS, Inc., Chicago, IL, US), with a significant p < 0.05.
The biomarkers p16 and Ki-67, separately or combined, showed no relation to recurrence on the total analysis. However, evaluating specifically HG lesions, the positive expression (2+ and 3 + ) of p16/Ki-67 was associated with recurrence (0.010). In addition, p16 isolated was also more expressive in HG lesions (2+ and 3 + , p= 0.018), but it was unrelated to recurrence.
Proteins p16 and Ki-67, both isolated and combined, are not reliable primary markers for the recurrence of cervical lesions in the majority of LG lesions. However, analyzing only the group with prior diagnosis of HG lesions, the expressions of p16 and of p16/Ki-67 were associated with recurrence, and they may be useful in monitoring these cases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(6):288-293
To evaluate the expressions of biomarkers p16 and Ki-67 in low-grade (LG) or high-grade (HG) lesions, and to relate them to risk factors and the recurrence of these lesions.
A retrospective case-control study of 86 patients with LG and HG lesions who underwent a loop electrosurgical excision procedure (LEEP) between 1999 and 2004. The control group was composed of 69 women with no recurrence, and the study group, of 17 patients with recurrence. All patients were followed-up over a two-year period after surgery, and screened every six months, including cytology and colposcopy. Biopsy samples collected from LEEP were submitted to immunohistochemical analysis for p16 and Ki-67. The statistical analysis was performed using the Statistical Package for the Social Sciences software (SPSS, IBM-SPSS, Inc., Chicago, IL, US), with a significant p < 0.05.
The biomarkers p16 and Ki-67, separately or combined, showed no relation to recurrence on the total analysis. However, evaluating specifically HG lesions, the positive expression (2+ and 3 + ) of p16/Ki-67 was associated with recurrence (0.010). In addition, p16 isolated was also more expressive in HG lesions (2+ and 3 + , p= 0.018), but it was unrelated to recurrence.
Proteins p16 and Ki-67, both isolated and combined, are not reliable primary markers for the recurrence of cervical lesions in the majority of LG lesions. However, analyzing only the group with prior diagnosis of HG lesions, the expressions of p16 and of p16/Ki-67 were associated with recurrence, and they may be useful in monitoring these cases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(9):536-544
DOI 10.1590/S0100-72032006000900006
PURPOSE: to evaluate risk factors associated with cervical intraepithelial lesion recurrence after LEEP conization. METHODS: nested case-control study in a cohort of 201 patients with cervical intraepithelial lesion, that were submitted to LEEP conization. Average follow-up of these patients was 2 years. Ninety-four HIV-infected women and 107 non-infected were enrolled. Cervical conization was achieved by the Loop Electrosurgical Excision Procedure (LEEP). Evaluated surgical biopsy histopathological characteristics were lesion grade, lesion borders and glandular involvement. After surgery all patients were submitted to a colposcopy and cytological evaluation every six months. Recurrent lesions were defined it confirmed by biopsy after surgery. Cases were patients with and controls patients without recurrence. chi2 test and multivariable analysis by logistic regression were used for group comparisons. Kaplan Meier's method was performed for the survival analyses (log-rank test). RESULTS: 40 patients had lesion recurrence. Initially, significant variables were: partner number, HIV-infection, lesion borders and glandular involvement. The most frequent recurrence occurred when there were simultaneous association between positive margins and glandular involvement as indicator for recurrence risk. After logistic regression analysis the main factors associated with lesion recurrence were: glandular involvement (OR-9.1; 95% CI:13.0- 27.5); HIV-infection (OR-4.6; 95% IC:1.1-6.3); compromised margins (OR-2.6; 95% IC:1.9-11.2). CONCLUSIONS: risk factors associated with cervical intraepitelial lesion recurrence were HIV-infection, glandular involvement and compromised margins.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(9):536-544
DOI 10.1590/S0100-72032006000900006
PURPOSE: to evaluate risk factors associated with cervical intraepithelial lesion recurrence after LEEP conization. METHODS: nested case-control study in a cohort of 201 patients with cervical intraepithelial lesion, that were submitted to LEEP conization. Average follow-up of these patients was 2 years. Ninety-four HIV-infected women and 107 non-infected were enrolled. Cervical conization was achieved by the Loop Electrosurgical Excision Procedure (LEEP). Evaluated surgical biopsy histopathological characteristics were lesion grade, lesion borders and glandular involvement. After surgery all patients were submitted to a colposcopy and cytological evaluation every six months. Recurrent lesions were defined it confirmed by biopsy after surgery. Cases were patients with and controls patients without recurrence. chi2 test and multivariable analysis by logistic regression were used for group comparisons. Kaplan Meier's method was performed for the survival analyses (log-rank test). RESULTS: 40 patients had lesion recurrence. Initially, significant variables were: partner number, HIV-infection, lesion borders and glandular involvement. The most frequent recurrence occurred when there were simultaneous association between positive margins and glandular involvement as indicator for recurrence risk. After logistic regression analysis the main factors associated with lesion recurrence were: glandular involvement (OR-9.1; 95% CI:13.0- 27.5); HIV-infection (OR-4.6; 95% IC:1.1-6.3); compromised margins (OR-2.6; 95% IC:1.9-11.2). CONCLUSIONS: risk factors associated with cervical intraepitelial lesion recurrence were HIV-infection, glandular involvement and compromised margins.
