Physical exercise on inflammatory markers in type 2 diabetes patients: a systematic review of randomized controlled trials

Background. Type 2 diabetes mellitus (T2DM) is a serious disease associated with high morbidity and mortality. Scientific findings showed that physical exercise is an option for treatment of these patients. This study's objective is to investigate the effects of supervised aerobic and/or resistance physical training on inflammatory markers in subjects with T2DM. Methods. A systematic review was conducted on four databases, MEDLINE, CENTRAL, LILACS, and Scopus, and manual search from 21 to 30 November 2016. Randomized clinical trials involving individuals diagnosed with T2DM, who have undergone supervised training protocols, were selected in this study. Results. Eleven studies were included. Studies that evaluated control group versus aerobic exercise reported controversial results about the effectiveness of physical training in modifying C-reactive protein (CRP) and cytokine levels. The only variable analyzed by the six studies in comparison to the control group versus resistance exercise was CRP. This protein showed no significant difference between groups. Between the two modes of exercise (aerobic and resistance), only one study demonstrated that aerobic exercise was more effective in reducing CRP. Conclusion. The evidence was insufficient to prove that aerobic or resistance exercise improves systemic levels of inflammatory markers in patients with T2DM

Prognostic value of Dna and Mrna E6/e7 of human papillomavirus in the evolution of cervical intraepithelial neoplasia grade 2

Objective: This study aimed at evaluating whether human papillomavirus (HPV) groups and E6/E7 mRNA of HPV 16, 18, 31, 33, and 45 are prognostic of cervical intraepithelial neoplasia (CIN) 2 outcome in women with a cervical smear showing a low-grade squamous intraepithelial lesion (LSIL).Methods: This cohort study included women with biopsy-confirmed CIN 2 who were followed up for 12 months, with cervical smear and colposcopy performed every three months.Results: Women with a negative or low-risk HPV status showed 100% CIN 2 regression. The CIN 2 regression rates at the 12-month follow-up were 69.4% for women with alpha-9 HPV versus 91.7% for other HPV species or HPV-negative status (P < 0.05). For women with HPV 16, the CIN 2 regression rate at the 12-month follow-up was 61.4% versus 89.5% for other HPV types or HPV-negative status (P < 0.05). The CIN 2 regression rate was 68.3% for women who tested positive for HPV E6/E7 mRNA versus 82.0% for the negative results, but this difference was not statistically significant.Conclusions: The expectant management for women with biopsy-confirmed CIN 2 and previous cytological tests showing LSIL exhibited a very high rate of spontaneous regression. HPV 16 is associated with a higher CIN 2 progression rate than other HPV infections. HPV E6/E7 mRNA is not a prognostic marker of the CIN 2 clinical outcome, although this analysis cannot be considered conclusive. Given the small sample size, this study could be considered a pilot for future larger studies on the role of predictive markers of CIN 2 evolution. © the authors.This study aimed at evaluating whether human papillomavirus (HPV) groups and E6/E7 mRNA of HPV 16, 18, 31, 33, and 45 are prognostic of cervical intraepithelial neoplasia (CIN) 2 outcome in women with a cervical smear showing a low-grade squamous intraepithelial lesion (LSIL).Methods: This cohort study included women with biopsy-confirmed CIN 2 who were followed up for 12 months, with cervical smear and colposcopy performed every three months.Results: Women with a negative or low-risk HPV status showed 100% CIN 2 regression. The CIN 2 regression rates at the 12-month follow-up were 69.4% for women with alpha-9 HPV versus 91.7% for other HPV species or HPV-negative status (P < 0.05). For women with HPV 16, the CIN 2 regression rate at the 12-month follow-up was 61.4% versus 89.5% for other HPV types or HPV-negative status (P < 0.05). The CIN 2 regression rate was 68.3% for women who tested positive for HPV E6/E7 mRNA versus 82.0% for the negative results, but this difference was not statistically significant.Conclusions: The expectant management for women with biopsy-confirmed CIN 2 and previous cytological tests showing LSIL exhibited a very high rate of spontaneous regression. HPV 16 is associated with a higher CIN 2 progression rate than other HPV infections. HPV E6/E7 mRNA is not a prognostic marker of the CIN 2 clinical outcome, although this analysis cannot be considered conclusive. Given the small sample size, this study could be considered a pilot for future larger studies on the role of predictive markers of CIN 2 evolution9152

Diagnostic and therapeutic challenges in the management of glandular abnormalities of the cervix

Glandular abnormalities comprise less than one-quarter of the diseases affecting the uterine cervix. The acquisition of knowledge on the epidemiological and biological features of glandular lesions of the cervix has occurred more slowly compared with the progress associated with squamous cell lesions. This difference is principally due to the greater prevalence of squamous cells lesions compared with that of glandular lesions. Evidence-based management guidelines are lacking for the most severe forms of glandular abnormalities of the cervix, in particular for invasive adenocarcinomas. This review summarizes the epidemiology, natural history and diagnosis of glandular abnormalities of the cervix and the current debate on the management of cervical in situ and invasive adenocarcinomas.Glandular abnormalities comprise less than one-quarter of the diseases affecting the uterine cervix. The acquisition of knowledge on the epidemiological and biological features of glandular lesions of the cervix has occurred more slowly compared with the progress associated with squamous cell lesions. This difference is principally due to the greater prevalence of squamous cells lesions compared with that of glandular lesions. Evidence-based management guidelines are lacking for the most severe forms of glandular abnormalities of the cervix, in particular for invasive adenocarcinomas. This review summarizes the epidemiology, natural history and diagnosis of glandular abnormalities of the cervix and the current debate on the management of cervical in situ and invasive adenocarcinomas71495

A Portrait Of Single And Multiple Hpv Type Infections In Brazilian Women Of Different Age Strata With Squamous Or Glandular Cervical Lesions

Background: Cervical cancer ranks third in prevalence and fourth as cause of death in women worldwide. In Brazil, 17,540 women were diagnosed in 2012 with the disease. Persistent infection with high-risk HPV types is a necessary condition for the development of pre-invasive and invasive cervical neoplasia. Currently, over 100 HPV types have been identified, but HPV16 and 18 are recognized as the mayor culprits in cervical carcinogenesis. Our objective was to assess the relationships between single- (ST) and multiple-type (MT) HPV infections with patients' age and lesion pathological status.Methods: 328 patients with either squamous or glandular intraepithelial or invasive cervical lesion were selected. All subjects were tested for HPV genotypes with reverse hybridization for 21 high- (hr-HPV) and 16 low-risk (lr-HPV) probes. Prevalence of ST and MT HPV infections was compared across histological types and age strata.Results: 287 (87%) women had at least one HPV type detected and 149 (52%) had MT infections. The most prevalent HPV type was HPV16, present in 142 cases (49% of all HPV-positive cases), followed by HPV58, 52, 31, 35 and 33. HPV18, in single or multiple infections, occurred in 23 cases (8% of hr-HPV cases). Almost all glandular lesions were associated with HPV16 and 18 alone. Multiple infections were significantly more prevalent in squamous than in glandular lesion for HPV16 and 18 (P = 0.04 and 0.03 respectively). The prevalence of MT infections followed a bimodal distribution; peaking in women younger 29 years and in those aged 50 to 59.Conclusions: Our data indicate that prevention strategies for pre-invasive and invasive squamous lesions should be focused on HPV16 and a few alpha-9 HPV types. It is clear to us that in young women, prophylaxis must cover a large amalgam of HPV types beyond classic HPV16 and 18. © 2014 Resende et al.; licensee BioMed Central Ltd.141Globocan 2008. Planning and Implementing Cervical Cancer Prevention and Control Programs - A manual for managers. Alliance for Cervical Cancer Prevention 2008 http://screening.iarc.fr/manual/ACCP_screen.pdf, IARC - International Agency for Research on Cancer. World Health OrganizationMinistério da Saúde. Coordenação nacional de prevenção e vigilância do câncer. Incidência do câncer no Brasil 2012 http://www.inca.gov.br/estimativa/2014/, INCA - Instituto Nacional do CâncerZur, H.H., Papillomaviruses and cancer: from basic studies to clinical application (2002) Nat Rev Cancer, 2 (5), pp. 342-350. , 10.1038/nrc798, 12044010Schiffman, M., Castle, P.E., Human Papillomavirus: epidemiology and public health (2003) Arch Pathol Lab Med, 127 (8), pp. 930-934Chen, H.C., You, S.L., Hsieh, C.Y., Schiffman, M., Lin, C.Y., Pan, M.H., Chou, Y.C., Chen, C.J., Prevalence of genotype-specific human papillomavirus infection and cervical neoplasia in Taiwan: a community-based survey of 10,602 women (2011) Int J Cancer, 128 (5), pp. 1192-1203. , 10.1002/ijc.25685, 20853317, CBCSP-HPV Study GroupKhan, S., Jaffer, N.N., Khan, M.N., Rai, M.A., Shafiq, M., Ali, A., Pervez, S., Ali, S.H., Human papillomavirus subtype 16 is common in Pakistani women with cervical carcinoma (2007) Int J Infect Dis, 11 (4), pp. 313-317. , 10.1016/j.ijid.2006.06.007, 17291804Mirabello, L., Schiffman, M., Ghosh, A., Rodriguez, A.C., Vasiljevic, N., Wentzensen, N., Herrero, R., Lorincz, A.T., Elevated methylation of HPV16 DNA is associated with the development of high grade cervical intraepithelial neoplasia (2013) Int J Cancer, 132 (6), pp. 1412-1422. , 10.1002/ijc.27750, 3493709, 22847263Pantawala, I.Y., Bauer, H.M., Miyamoto, J., Park, I.U., Huchko, M.J., Smith-McCune, K.K., A systematic review of randomized trials assessing human papillomavirus testing in cervical cancer screening (2013) Am J Obstet Gynecol, 208 (5), pp. 343-353. , 10.1016/j.ajog.2012.11.013, 3686555, 23159693Schiffman, M., Castle, P.E., Jeronimo, J., Rodriguez, A.C., Wacholder, S., Human Papillomavirus and cervical cancer (2007) Lancet, 370 (9590), pp. 890-907. , 10.1016/S0140-6736(07)61416-0, 17826171Kjær, S.K., Frederiksen, K., Munk, C., Iftner, T., Long-term absolute risk of cervical intraepithelial neoplasia grade 3 or worse following human papillomavirus infection: role of persistence (2010) J Natl Cancer Inst, 102 (19), pp. 1478-1488. , 10.1093/jnci/djq356, 2950170, 20841605Argyri, E., Papaspyridakos, S., Tsimplaki, E., Michala, L., Myriokefalitaki, E., Papassideri, I., Daskalopoulou, D., Panotopoulou, E., A cross sectional study of HPV type prevalence according to age and cytology (2013) BMC Infect Dis, 13, p. 53. , 10.1186/1471-2334-13-53, 3575232, 23363541Pista, A., de Oliveira, C.F., Cunha, M.J., Paixao, M.T., Real, O., Prevalence of human papillomavirus infection in women in Portugal: the CLEOPATRE Portugal Study (2011) Int J Gynecol Cancer, 21 (6), pp. 1150-1158. , 10.1097/IGC.0b013e31821dd3b2, 21792018Wentzensen, N., Sun, C., Ghosh, A., Kinney, W., Mirabello, L., Wacholder, S., Shaber, R., Burk, R.D., Methylation of HPV18, HPV31, and HPV45 genomes and cervical intraepithelial neoplasia grade 3 (2012) J Natl Cancer Inst, 104 (22), pp. 1738-1749. , 10.1093/jnci/djs425, 3571257, 23093560Nayar, R., Solomon, D., Second edition of The Bethesda System for reporting cervical cytology - atlas, website, and Bethesda interobserver reproducibility project (2004) CytoJournal, 1 (1), p. 4. , 10.1186/1742-6413-1-4, 526759, 15504231Scully, R.E., Bonfiglio, T.A., Kurman, R.J., Silverberg, S.G., Wilkins, E.J., Histological Typing of Female Genital Tract Tumors (1994) World Health Organization. International Histological Classification of Tumors, pp. 36-49. , Berlin: Springer-Verlag, 2Simonella, L.M., Lewis, H., Smith, M., Neal, H., Bromhead, C., Canfell, K., Type-specific oncogenic human papillomavirus infection in high grade cervical disease in New Zealand (2013) BMC Infect Dis, 13, p. 114. , 10.1186/1471-2334-13-114, 3607885, 23452957Quint, K.D., de Koning, M.N., van Doorn, L.J., Quint, W.G., Pirog, E.C., HPV genotyping and HPV16 variant analysis in glandular and squamous neoplastic lesions of the uterine cervix (2010) Gynecol Oncol, 117 (2), pp. 297-301. , 10.1016/j.ygyno.2010.02.003, 20207397Kirschner, B., Schledermann, D., Holl, K., Rosenlund, M., Raillard, A., Quint, W., Molijn, A., Junge, J., HPV-genotypes in high-grade intraepithelial cervical lesions in Danish women (2013) Acta Obstet Gynecol Scand, 92 (9), pp. 1032-1040. , 10.1111/aogs.12162, 23647074Roteli-Martins, C.M., de Carvalho, N.S., Naud, P., Teixeira, J., Borba, P., Derchain, S., Tyring, S., Dubin, G., Prevalence of human papillomavirus infection and associated risk factors in young women in Brazil, Canada, and the United States: a multicenter cross-sectional study (2011) Int J Gynecol Pathol, 30 (2), pp. 173-184Balbi, G., Napolitano, A., Giordano, F., Capuano, S., Manganaro, M.A., Di Martino, L., Fusco, D., Seguino, E., Role of the association of high-risk HPV identified by real-time PCR in cervical preneoplastic lesions (2012) Eur J Gynaecol Oncol, 33 (5), pp. 467-471Trottier, H., Mahmud, S., Costa, M.C., Sobrinho, J.P., Duarte-Franco, E., Rohan, T.E., Ferenczy, A., Franco, E.L., Human papillomavirus infections with multiple types and risk of cervical neoplasia (2006) Cancer Epidemiol Biomarkers Prev, 15 (7), pp. 1274-1280. , 10.1158/1055-9965.EPI-06-0129, 16835323Figueiredo Alves, R.R., Turchi, M.D., Santos, L.E., Guimarães, E.M., Garcia, M.M., Seixas, M.S., Villa, L.L., Alves, M.D., Prevalence, genotype profile and risk factors for multiple human papillomavirus cervical infection in unimmunized female adolescents in Goiania, Brazil: a community-based study (2013) BMC Public Health, 13 (1), p. 1041. , 10.1186/1471-2458-13-1041, 3819257, 24188572Campos, N.G., Rodriguez, A.C., Castle, P.E., Herrero, R., Hildesheim, A., Katki, H., Kim, J.J., Schiffman, M., Persistence of concurrent infections with multiple human papillomavirus types: a population-based cohort study (2011) J Infect Dis, 203, pp. 823-827. , 10.1093/infdis/jiq131, 3071138, 21257737Smith, J.S., Lindsay, L., Hoots, B., Keys, J., Franceschi, S., Winer, R., Clifford, G.M., Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical lesions: a meta-analysis update (2007) Int J Cancer, 121 (3), pp. 621-632. , 10.1002/ijc.22527, 17405118Oliveira-Silva, M., Lordello, C.X., Zardo, L.M., Bonvicino, C.R., Moreira, M.A., Human Papillomavirus in Brazilian women with and without cervical lesions (2011) Virol J, 8, p. 4. , 10.1186/1743-422X-8-4, 3024957, 21208414Fernandes, J.V., Meissner, R.V., Carvalho, M.G., Fernandes, T.A., Azevedo, P.R., Sobrinho, J.S., Prado, J.C., Villa, L.L., Prevalence of human papillomavirus in archival samples obtained from patients with cervical pre-malignant and malignant lesions from Northeast Brazil (2010) BMC Res Notes, 3 (1), p. 96. , 10.1186/1756-0500-3-96, 2857859, 20377903Van de Velde, N., Boily, M.C., Drolet, M., Franco, E.L., Mayrand, M.H., Kliewer, E.V., Coutlée, F., Brisson, M., Population-level impact of the bivalent, quadrivalent, and nonavalent human Papillomavirus Vaccines: a model-based analysis (2012) J Natl Cancer Inst, 104, pp. 1712-1723. , 10.1093/jnci/djs395, 2310432

Atypical Glandular Cells And Adenocarcinoma In Situ According To The Bethesda 2001 Classification: Cytohistological Correlation And Clinical Implications

Background: The objective of this study was to evaluate the correlation between the 2001 Bethesda classification of endocervical glandular abnormalities and histological diagnosis. Study design: A series of 155 women with endocervical glandular abnormalities on cervical smears were included: 91 with atypical glandular cells (AGC) not otherwise specified (NOS), 15 with AGC-favor neoplastic (FN); 35 with AGC associated with high-grade squamous intraepithelial lesion (HSIL) as combined diagnosis and 14 with adenocarcinoma in situ (AIS). Results: Histological outcome of squamous neoplasias (CIN 2 or worse) and adenocarcinoma were significantly associated with AGC-FN and AIS, taking as reference AGC-NOS, and more associated with AIS than AGC-FN. Similar associations were observed for histological outcome of adenocarcinoma, but no association was observed for only squamous neoplasia. Histological outcome of CIN2 or worse was strongly associated with AGC when HSIL was also present, but no association was observed with only for adenocarcinoma histological outcome. Conclusions: AGC-NOS, AGC-FN and AIS cytological diagnosis represent a progressively increasing association with neoplastic diagnosis, due to progressively increasing association with adenocarcinoma. Histological outcome of squamous neoplasia is frequent but does not differ with these cytological interpretations. The presence of HSIL associated with AGC represents greater probability of squamous neoplasia but not adenocarcinoma. © 2007 Elsevier Ireland Ltd. All rights reserved.13917985Tam, K.F., Cheung, A.N., Liu, K.L., A retrospective review on atypical glandular cells of undetermined significance (AGUS) using the Bethesda 2001 classification (2003) Gynecol Oncol, 91 (3), pp. 603-607Scheiden, R., Wagener, C., Knolle, U., Dippel, W., Capesius, C., Atypical glandular cells in conventional cervical smears: incidence and follow-up (2004) BMC Cancer, 4, p. 37Wright Jr., T.C., Cox, J.T., Massad, L.S., Twiggs, L.B., Wilkinson, E.J., 2001 Consensus Guidelines for the management of women with cervical cytological abnormalities (2002) JAMA, 287 (16), pp. 2120-2129. , ASCCP-Sponsored Consensus ConferenceCovell, J.L., Wilbur, D.C., Guidos, B., Lee, K.R., Chhieng, D.C., Mody, D.R., Epithelial abnormalities: glandular (2004) The Bethesda System for reporting cervical cytology: definitions, criteria and explanatory notes, pp. 123-156. , Solomon D., and Nayar R. (Eds), Springer-Verlag, New YorkCangiarella, J.F., Chhieng, D.C., Atypical glandular cells-an update (2003) Diagn Cytopathol, 29 (5), pp. 271-279Daniel, A., Barreth, D., Schepansky, A., Johnson, G., Capstick, V., Faught, W., Histologic and clinical significance of atypical glandular cells on pap smears (2005) Int J Gynaecol Obstet, 91 (3), pp. 238-242Levine, L., Lucci III, J.A., Dinh, T.V., Atypical glandular cells: new Bethesda Terminology and Management Guidelines (2003) Obstet Gynecol Surv, 58 (6), pp. 399-406Derchain, S.F., Rabelo-Santos, S.H., Sarian, L.O., Human papillomavirus DNA detection and histological findings in women referred for atypical glandular cells or adenocarcinoma in situ in their Pap smears (2004) Gynecol Oncol, 95 (3), pp. 618-623Chhieng, D.C., Elgert, P.A., Cangiarella, J.F., Cohen, J.M., Clinical significance of atypical glandular cells of undetermined significance. A follow-up study from an academic medical center (2000) Acta Cytol, 44 (4), pp. 557-566Simsir, A., Hwang, S., Cangiarella, J., Glandular cell atypia on Papanicolaou smears: interobserver variability in the diagnosis and prediction of cell of origin (2003) Cancer, 99 (6), pp. 323-330Chhieng, D.C., Gallaspy, S., Yang, H., Roberson, J., Eltoum, I., Women with atypical glandular cells: a long-term follow-up study in a high-risk population (2004) Am J Clin Pathol, 122 (4), pp. 575-579Sharpless, K.E., Schnatz, P.F., Mandavilli, S., Greene, J.F., Sorosky, J.I., Dysplasia associated with atypical glandular cells on cervical cytology (2005) Obstet Gynecol, 105 (3), pp. 494-500. , [Erratum in: Obstet Gynecol 2005;105(6):1495]Selvaggi, S.M., Cytologic features of high-grade squamous intraepithelial lesions involving endocervical glands on ThinPrep cytology (2002) Diagn Cytopathol, 26 (3), pp. 181-185Segal, A., Frost, F.A., Miranda, A., Fletcher, C., Sterrett, G.F., Predictive value of diagnoses of endocervical glandular abnormalities in cervical smears (2003) Pathology, 35 (3), pp. 198-203Solomon D, Davey D, Kurman R, et al. Forum Group MembersBethesda 2001 Workshop. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA 2002;287(16):2114-19Wright, T.C., Gastcha, R.M., Luff, R.D., Prey, M.U., Epithelial cell abnormalities: squamous (2004) The Bethesda System for reporting cervical cytology. Definitions, criteria, and explanatory notes, , Springer-Verlag, New York pp. 123-156Scully, R.E., Bonfiglio, T.A., Kurman, R.J., Silverberg, S.G., Wilkins, E.J., Histological typing of female genital tract tumors (1994) World Health Organization - International histological classification of tumors. 2nd ed., , Springer-Verlag, Berlin pp. 36-49Gurbuz, A., Karateke, A., Kabaca, C., Kir, G., Atypical glandular cells: improvement in cytohistologic correlation by the 2001 Bethesda system (2005) Int J Gynecol Cancer, 15 (5), pp. 903-910Confortini, M., Di Bonito, L., Carozzi, F., Interlaboratory reproducibility of atypical glandular cells of undetermined significance: a national survey (2006) Cytopathology, 17 (6), pp. 353-360. , GISCi Working Group for Cervical CytologyHaidupoulos, D.A., Stefanidis, K., Rodolakis, A., Pilalis, A., Symiakaki, I., Diakomanolis, E., Histologic implications of Pap smears classified as atypical glandular cells (2005) J Reprod Med, 50 (7), pp. 539-542Roberts, J., Thurloe, J.K., Biro, C., Hyne, S.G., Williams, K.E., Bowditch, R.C., Follow-up of cytologic predictions of endocervical glandular abnormalities: histologic outcomes in 123 cases (2005) J Low Genit Tract Dis, 9 (2), pp. 71-77A randomized trial on the management of low-grade squamous intraepithelial lesion cytology interpretations (2003) Am J Obstet Gynecol, 188 (6), pp. 1393-1400. , ASCUS-LSIL Traige Study (ALTS) GroupResults of a randomized trial on the management of cytology interpretations of atypical squamous cells of undetermined significance (2003) Am J Obstet Gynecol, 188 (6), pp. 1383-1392. , ASCUS-LSIL Traige Study (ALTS) GroupRonnet, B.M., Manos, M.M., Ransley, J.E., Atypical glandular cells of undetermined significance: cytopathologic features, histopathologic results, and human papillomavirus DNA detection (1999) Hum Pathol, 30 (7), pp. 816-825Oliveira, E.R., Derchain, S.F., Rabelo-Santos, S.H., Detection of high-risk human papillomavirus (HPV) DNA by Hybrid Capture II in women referred due to atypical glandular cells in the primary screening (2004) Diagn Cytopathol, 31 (1), pp. 19-22Krane, J.F., Lee, K.R., Sun, D., Yuan, L., Crum, C.P., Atypical glandular cells of undetermined significance. Outcome predictions based on human papillomavirus testing (2004) Am J Clin Pathol, 121 (1), pp. 87-92Geier, C.S., Wilson, M., Creasman, W., Clinical evaluation of atypical glandular cells of undetermined significance (2001) Am J Obstet Gynecol, 184 (2), pp. 64-69van Aspert-van Erp, A.J., Smedts, F.M., Vooijs, G.P., Severe cervical glandular cell lesions with coexisting squamous cell lesions (2004) Cancer, 102 (4), pp. 218-227Drijkoningen, M., Meertens, B., Lauweryns, J., High grade squamous intraepithelial lesion (CIN3) with extension into the endocervical clefts. Difficulty of cytologic differentiation from adenocarcinoma in situ (1996) Acta Cytol, 40 (5), pp. 889-894Renshaw, A.A., Mody, D.R., Lozano, R.L., Detection of adenocarcinoma in situ of the cervix in Papanicolaou tests: comparison of diagnostic accuracy with other high-grade lesions (2004) Arch Pathol Lab Med, 128 (2), pp. 153-15

Association between Hpv types and species groups and cervical neoplasia from a high-risk area for cervical cancer, Goiânia, Brazil

CNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOThis study was designed to evaluate the effect of single or multiple-human papillomavirus (HPV) infection and phylogenetic groups on the prevalence and severity of cervical intraepithelial neoplasia (CIN) in women undergoing colposcopy after an abnormal cervical smear. Colposcopy was performed in 198 cases and biopsy was performed in 193 patients. All specimens were tested for 27 HPV genotypes using the Roche polymerase chain reaction reverse line blot assay. The overall prevalence of HPV infection in women with an abnormal cervical smear was 86% (171 of 198). The prevalence of HPV 16 in high-grade CIN (2/3) was 52% (40 of 76), being detected in 88.8% of cases (8 of 9) of invasive carcinoma. The prevalence of HPV types 31 and 35 in high-grade CIN was 10.5% (8 of 76) and 6.6% (5 of 76), respectively. Single or multiple-type infection involving HPV 16 were significantly associated with a diagnosis of high-grade neoplasia (≥2) [odds ratio (OR) 6.49; 95% confidence interval (CI): 1.88-23.44 and OR: 3.65; 95% CI: 1.13-12.15] even after adjustment for HPV-DNA. A statistically significant association was also found between HPV 16 and the other HPV types belonging to species α 9 and a diagnosis of high-grade neoplasia (OR: 7.62; 95% CI: 1.28-51.58); however, no association was found between HPV 16 and the other HPV types belonging to species α 7. HPV 16 is the most important predictor of high-grade cervical neoplasia. Multiple-type infections are predictors of high-grade cervical neoplasia when type 16 is present. © 2011 International Society of Gynecological Pathologists.This study was designed to evaluate the effect of single or multiple-human papillomavirus (HPV) infection and phylogenetic groups on the prevalence and severity of cervical intraepithelial neoplasia (CIN) in women undergoing colposcopy after an abnormal cervical smear. Colposcopy was performed in 198 cases and biopsy was performed in 193 patients. All specimens were tested for 27 HPV genotypes using the Roche polymerase chain reaction reverse line blot assay. The overall prevalence of HPV infection in women with an abnormal cervical smear was 86% (171 of 198). The prevalence of HPV 16 in high-grade CIN (2/3) was 52% (40 of 76), being detected in 88.8% of cases (8 of 9) of invasive carcinoma. The prevalence of HPV types 31 and 35 in high-grade CIN was 10.5% (8 of 76) and 6.6% (5 of 76), respectively. Single or multiple-type infection involving HPV 16 were significantly associated with a diagnosis of high-grade neoplasia (≥2) [odds ratio (OR) 6.49; 95% confidence interval (CI): 1.88-23.44 and OR: 3.65; 95% CI: 1.13-12.15] even after adjustment for HPV-DNA. A statistically significant association was also found between HPV 16 and the other HPV types belonging to species α 9 and a diagnosis of high-grade neoplasia (OR: 7.62; 95% CI: 1.28-51.58); however, no association was found between HPV 16 and the other HPV types belonging to species α 7. HPV 16 is the most important predictor of high-grade cervical neoplasia. Multiple-type infections are predictors of high-grade cervical neoplasia when type 16 is present303288294CNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOCNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOsem informaçã