Adénocarcinome du col utérin au Gabon : caractéristiques clinico-pathologiques d’une série des cas

Contexte et objectifs. L’adénocarcinome du col utérin a fait l’objet de peu de publications notamment en Afrique. L’objectif de la présente étude était de décrire les aspects cliniques, pathologiques et évolutifs de ce cancer au Gabon puis d’évaluer la reproductibilité du pattern d’invasion (PI) afin d’améliorer le choix thérapeutique. Méthodes. Il s’agissait d’une série des cas d’adénocarcinomes du col utérin confirmés histologiquement en 8 ans. Les données clinico-pathologiques et le suivi ont été enregistrés à partir des dossiers médicaux. 3 pathologistes ont évalué le PI de chaque cas puis, la reproductibilité a été réalisée. Résultats. Sur les 378 cas recensés, 16 ont été retenus. Leur âge moyen était de 57 ans. Les femmes étaient de grandes multipares (68,7 %) et ayant consulté pour des métrorragies (87,5 %). Elles étaient récués à un stade clinique avancé (62,5 %) et l’évolution était défavorable dans 81,25 % des cas. Le type endocervical et le grade intermédiaire étaient les plus fréquents. Le niveau de concordance du PI était faible (28,6 %). Conclusion. L’adénocarcinome du col utérin au Gabon survient chez la femme d’âge jeune, grande multipare, est de diagnostic tardif et d’évolution péjorative d’où l’intérêt d’assurer un dépistage précoce et une prévention. Par ailleurs, la reproductibilité du PI devrait être réévaluée par des études supplémentaires. English title: Adenocarcinoma of the uterine cervix in Gabon: clinico-pathological characteristics of serial cases Context and objective. Little has been published on cervical adenocarcinoma, especially in Africa. The objective of the present study was to describe the clinical, pathological and follow-up aspects of this cancer in Gabon, then to evaluate the reproducibility of the invasion pattern (IP) in order to improve the therapeutic choice. Methods. It was a series of histologically confirmed cases of cervical adenocarcinoma over 8 years. Clinicopathological data and follow-up information were collected from medical records. 3 pathologists evaluated the IP of each case and then the reproducibility was carried out. Results. Of the 378 cases identified, 16 were selected. The average age was 57 years. The women were large multiparous (68.7 %), consulted for metrorrhagia (87.5%), had an advanced clinical stage (62.5 %) and evolution was often unfavourable (81.25%). Endocervical type and intermediate grade were the most frequent. The level of concordance of the IP was low (28.6 %). Conclusion. Adenocarcinoma of the uterine cervix in Gabon occurs in young, multiparous women, is diagnosed late and has a poor outcome, hence the interest of prevention. In addition, the reproducibility of the IP should be reevaluated by additional studies. Keywords : adénocarcinoma- clinico pathological aspects- uterine cervix Gabo

HPV genotypes in high-grade cervical lesions and invasive cervical carcinoma detected in Gabonese women

International audienceBackground Cervical cancer is the third most common cancer among women worldwide, but particularly affects women living in sub-Saharan Africa. Screening and vaccination programs are two prevention approaches that can reduce cervical cancer incidence. However, effective vaccination campaigns require better knowledge of the prevalence of the main human papillomavirus (HPV) genotypes reported in high-grade neoplastic lesions and invasive carcinomas in women. Methods All samples collected in this study were processed using standard histopathological methods with haematoxylin and eosin staining of the sections. Areas with abnormal cells were then identified. The HPV genotype was determined on the DNA extracted from the same sections using nested PCR followed by amplicon sequencing and real-time PCR specific to five different HPV genotypes (16, 18, 33, 45 and 58). Results A total of 132 Gabonese patients with high-grade neoplastic lesions were included in this study; 81% were squamous cell carcinomas (SCC). At least one HPV was detected in 92.4% patients; HPV16 (75.4%) was the most frequent genotype, followed by HPV18, 58, 45, 33 and 35. Moreover, histological analysis showed that SCC samples had 50% and 58.2% stage III and IV tumor cells, respectively, according to the FIGO classification. Finally, 36.9% of these stage III and IV patients were less than 50 years old. Conclusions Our results confirm the high prevalence of HPV16 and 18 genotypes among high-grade lesions in Gabonese women. This study confirms the need for a national strategy for early screening of precancerous lesions associated with a broad national vaccination program among non-sexually active women to significantly reduce the long-term cancer burden