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Cervical cancer is a major global health issue, ranking as the fourth most common cancer in women worldwide. Depending on stage, histology, and patient factors, the standard management of cervical cancer is a combination of treatment approaches, including (fertility- or non-fertility-sparing) surgery, radiotherapy, platinum-based chemotherapy, and novel systemic therapies such as bevacizumab, immune checkpoint inhibitors, and antibody-drug conjugates. While ambitious global initiatives seek to eliminate cervical cancer as a public health problem, the management of cervical cancer continues to evolve with major advances in imaging modalities, surgical approaches, identification of histopathological risk factors, radiotherapy techniques, and biomarker-driven personalized therapies. In particular, the introduction of immune checkpoint inhibitors has dramatically altered the treatment of cervical cancer, leading to significant survival benefits in both locally advanced and metastatic/recurrent settings. As the landscape of cervical cancer therapies continues to evolve, the aim of the present review is to provide a comprehensive discussion of the current state and the latest practice-changing updates in cervical cancer.
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The global incidence of cancer is increasing, including its incidence in women of reproductive age. Still, physicians encounter this situation rarely, which could lead to substandard care. This research sought to explore opportunities to improve future care for pregnant women with cancer, by describing the outcomes of a survey distributed to physicians all over the world focusing on clinical experience with pregnant women with cancer, the organization of care and current gaps in knowledge. We included 249 responses from physicians working across 36 countries. Responses demonstrate a wide variation in the organization of care - generally lacking centralization, and the physicians' acknowledgement of insufficient knowledge on the management of pregnant women with cancer. There is a need for improvement through national centralization and/or establishing advisory boards for cancer in pregnancy. Seeing the paucity of cancer in pregnancy experience, the importance of global multidisciplinary collaboration is emphasized.
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Neoplasias , Médicos , Feminino , Gravidez , Humanos , Gestantes , Inquéritos e Questionários , Neoplasias/terapiaRESUMO
In 2020, approximately 604 127 patients were newly diagnosed with cervical cancer and 341 831 died of the disease worldwide. Unfortunately, 85-90% of new cases and deaths occur in less developed countries. It is well known that persistent human papillomavirus (HPV) infection is the main risk factor for developing the disease. There are more than 200 HPV genotypes identified, but the most important in public health are the high-risk HPV genotypes including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59 due to their strong association with cervical cancer. Among these, genotypes 16 and 18 are responsible for about 70% of cervical cancer cases worldwide. Implementing systematic cytology-based screening, HPV screening, and HPV vaccination programs have successfully decreased the cervical cancer burden, particularly in developed countries. Although the etiological agent has been identified, we have seen the impact of well-conducted screening programs in developed countries, and we have available vaccines, the fight against this preventable disease has shown poor results globally. In November 2020 the World Health Organization launched its strategy to eliminate cervical cancer from the earth by 2130 (the goal is to achieve a global incidence lower than 4 per 100 000 women/year). The strategy aims to vaccinate 90% of girls before 15 years of age, to screen with a highly sensitive test (HPV-based) 70% of women at 35 and 45 years of age, and to provide proper treatment by trained personnel to 90% of women diagnosed with either cervical dysplasia or invasive cervical cancer. The objective of this review is to update the state of the art on primary and secondary prevention of cervical cancer.
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Infecções por Papillomavirus , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Prevenção Secundária , Países em Desenvolvimento , GenótipoRESUMO
Cervical cancer is the fourth most frequent cancer in women worldwide, representing nearly 8% of all female cancer deaths every year. The majority of cases of cervical cancer are caused by human papillomavirus (HPV); however, up to 5% of tumors are not associated with HPV-persistent infection and, moreover, the new WHO Female Genital Tumors classification subdivided cervical squamous and adenocarcinomas into HPV-associated and HPV-independent tumors. Based on this new information, the aim of this review is to provide an overview of HPV-independent cervical cancer, evaluating diagnostic techniques, molecular profiles, and clinical outcomes. The HPV-independent tumors are characterized by a differentiated molecular profile with lower proliferative activity, a p53 immunostaining, a decreased expression of cyclin-dependent kinase inhibitor proteins, such as p16, p14, and p27, and alterations in PTEN, p53, KRAS, CTNNB1, ARID1A, and ARID5B HPV-independent tumors are associated with both adenocarcinomas and squamous histologic subtypes, with lymph node involvement in the early stages, more distant metastasis, and generally worse oncological outcomes. Thus far, no specific therapeutic strategies have been developed based on HPV status; however, with advancing knowledge of differences in the molecular profiles and possible targetable alterations, novel approaches may offer potential options in the near future. Investigators should report on clinical outcomes, evaluating the overall response rates to specific treatments, and consider new biomarkers to establish more accurate prognostics factors.
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Neoplasias do Colo do Útero/genética , Alphapapillomavirus , Feminino , Humanos , Literatura de Revisão como Assunto , Neoplasias do Colo do Útero/virologiaRESUMO
OBJECTIVE: To compare, in vitro, the bioceramic materials (MTA and BC RRM-fast set putty) capacity to prevent microleakage of Enterococcus faecalis over time. METHODS: An experimental design was made with forty extracted human teeth, coronally cut, and prepared to be placed in a leakage system under sterile conditions. They were randomly divided into two experimental groups: thirty teeth (fifteen for each of retrograde filling material MTA and BC RRM-fast set putty) and a control group: ten teeth (five positive control, five negative control). The 3 mm root-ends were submerged in a brain-heart infusion broth with a red phenol indicator. The coronal access of each sample was inoculated with E. faecalis every seven days to maintain bacterial viability. The lower chamber was evaluated daily for 30 days to observe the turbidity of the culture medium and establish the presence and day of the filtration. Calculation of the colony-forming units (CFU) was performed for each leaked sample. Fisher's Exact Test was used to verify the association between the presence or absence of leakage of the samples by type of bioceramic material used and the Mann-Whitney U test to verify the existence of a difference between the average of CFU by type of bioceramic material used. The significance level used was α=0.05 and a 95% confidence level, as a decision rule for rejecting the null hypothesis. RESULTS: Of the total samples prepared for each group, leakage was found in 60.0% (9/15) of the MTA group and 40.0% (6/15) of the BC RRM-fast set putty group. All positive controls filtered on the first day of evaluation, while 20% (1/5) of the negative control leaked in the second week. There was no significant difference in leakege between the two groups, nor concerning the bacterial count (P=0.101) and the type of cement used (P=1.000). CONCLUSION: BC RRM-fast set putty was comparable to MTA in resisting bacterial microleakage during the observation time.
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Materiais Restauradores do Canal Radicular , Humanos , Compostos de Alumínio , Compostos de Cálcio , Óxidos , Fenóis , SilicatosRESUMO
OBJECTIVE: Cervical cancer is an important cause of mortality among women in developing countries, especially in the Latin America and Caribbean (LAC) region. Infection with high-risk (HR) human papillomavirus (HPV) has been identified as the primary cause of cervical cancer. The aim of this study was to determine the frequency of HR-HPV genotypes in low-grade and high-grade squamous intraepithelial lesions (LSIL, HSIL) and cervical carcinoma (CC) among Venezuelan women. MATERIALS AND METHODS: Subjects with histopathological diagnosis of LSIL, HSIL, and CC (LSIL=200; HSIL=100; CC=150) were enrolled in the study after obtaining informed consent. Biopsy samples of these subjects were analyzed to determine the lesion type. HPV detection and typing was done using polymerase chain reaction (PCR) and reverse hybridization. HPV type specific prevalence was determined in subjects with single and multiple infections. RESULTS: HPV DNA was detected in 68%, 95%, and 98.7% of LSIL, HSIL, and CC cases, respectively. HR-HPV and low-risk oncogenic HPV (LR-HPV) was observed in 66.9%/11.8% of LSIL cases, 87.3%/3.2% of HSIL cases, and 91.2%/0.7% of CC cases. HPV types -16/-18 (65%) were the most common high-risk HPV types observed, followed by types -52, -33, -45, and -31. CONCLUSION: Cervical cancer burden in Venezuelan women is substantial. HPV types -16/-18 were the most common types prevalent among Venezuelan women followed by types -52, -33, -45, and -31 (prevalence, ~90.1%). The results of this study provide baseline information on the HPV type distribution, which may facilitate the development of a cervical cancer prevention and control program in Venezuela.
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Alphapapillomavirus/genética , Infecções por Papillomavirus/virologia , Displasia do Colo do Útero/virologia , Neoplasias do Colo do Útero/virologia , Adolescente , Idoso , Alphapapillomavirus/isolamento & purificação , Feminino , Genótipo , Papillomavirus Humano 16/genética , Papillomavirus Humano 16/isolamento & purificação , Papillomavirus Humano 18/genética , Papillomavirus Humano 18/isolamento & purificação , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/patologia , Prevalência , Estudos Retrospectivos , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/patologia , Venezuela/epidemiologia , Adulto Jovem , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/patologiaRESUMO
Human papillomavirus (HPV) is the causative agent of cervical cancer (CC), the second most common cause of cancer deaths in Venezuela. Early detection and prompt treatment of precancerous lesions prevent up to 80% of CC cases. In Venezuela, difficult access to CC screening means that the disease is detected at advanced stages, especially in more vulnerable indigenous populations. The aim of the study was to detect precancerous cervical lesions and HPV infection in 60 women who attended the gynaecology service at the Maniapure Outpatient Clinic in Bolivar State, Venezuela. The study was carried out to detect precancerous cervical lesions using visual inspection with acetic acid (VIA), the Schiller test and conventional cytology (Pap testing). HPV detection and typing were carried out using the polymerase chain reaction. 58.3% of the women in the study belonged to the Eñepa indigenous community and 41.7% were white Creole women. The Schiller test showed irregularities in the staining of the exocervical epithelium in 8.33% of the patients, suggesting HPV infection. VIA was positive for 10.0% of the women. In the cytopathology report, 81.67% tested negative for intraepithelial lesions. The overall frequency of HPV detection was 35.0%. HPV infection was detected in 45.71% of the Eñepa women and 20.0% of the Creole women. 71.43% of the women had a high-risk single HPV infection. The percentage of viral infection was lower in the Creole patients than in the indigenous population; therefore, CC screening programmes in the latter population need to be improved.
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AIM: To detect human papilloma virus (HPV) presence and to characterize cellular immune response in breast cancer patients. METHODS: A total of 74 women were included, of which 48 samples were from patients diagnosed with breast cancer and 26 patients with benign pathology of the breast. Molecular subtype classification was performed based on the immunohistochemical reports of the tumor piece. HPV genome detection and genotyping from fresh breast biopsies was performed using the INNO-LIPA HPV Genotyping Extra test (Innogenetics, Ghent, Belgium). CD3+, CD4+, CD8+ and natural killer (NK)+ cells levels from peripheral blood samples from patients with breast cancer and benign pathology were measured by flow cytometry. RESULTS: Luminal A was the most frequent breast cancer molecular subtype (33.33%). HPV was detected in 25% of the breast cancer patients, and genotype 18 was the most frequent in the studied population. The mean of CD3+, CD4+ and CD8+ subpopulations were decreased in patients with breast cancer, in relation to those with benign pathology, with a statistically significant difference in CD8+ values (P = 0.048). The mean of NK+ cells was increased in the benign pathology group. The average level of CD3+, CD4+, CD8+ and NK+ cells decreased as the disease progressed. HER2+ and Luminal B HER2+ tumors had the lowest counts of cell subsets. HPV breast cancer patients had elevated counts of cellular subsets. CONCLUSION: Determining level changes in cellular subsets in breast cancer patients is a useful tool to evaluate treatment response.
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Breast cancer accounts for 16% of all female cancers worldwide, and in Venezuela, it is the leading cause of death among women. Recently, the presence of high-risk genotypes of human papillomavirus (HPV) has been demonstrated in breast cancer and has been associated with histopathological features of the tumours. In Venezuela, there is no study which determines the association between the presence of HPV in breast cancer and the histopathological features. The aim of this investigation is to evaluate the presence of HPV in the different types of breast cancer, according to their molecular classification, based on the expression of ER, PR, HER2 and Ki67. With this purpose in mind, we assessed the presence of the HPV genome in 24 breast cancer samples diagnosed with infiltrating ductal carcinoma, ductal carcinoma in situ (DCIS) and lobular carcinoma, by the INNO-LIPA genotyping extra kit and the evaluation of the markers ER, PR, HER2, and Ki67 by immunohistochemistry. The viral genome was found in 41.67% of the total number of samples, 51 being the most frequent genotype with 30.77%, followed by types 18 and 33, with 23.08%, respectively. Most tumours were found in the group of luminal A, with a low range of Ki67 expression. The presence of HPV in breast tumours could affect their growth pattern and metastatic power.
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Objetivo. Realizar la detección y tipificación de virus papiloma humano (VPH) en la cavidad bucal de un grupo de pacientes VIH positivos, atendidos en el Centro de Atención de Pacientes con Enfermedades Infectocontagiosas (CAPEI) de la Facultad de Odontología-Universidad Central de Venezuela. Métodos. Se evaluaron 31 hisopados bucales de pacientes VIH positivos para la infección por VPH, mediante el Sistema de Hibridación Reversa de INNO-LiPA que detecta 28 genotipos de VPH de alto y bajo riesgo oncogénico. Resultados. El 61,0% de las muestras evaluadas presentó infección por VPH. El genotipo 6 fue el más frecuente (73,68%), seguido de los genotipos 18, 11 y 16 con 63,16%, 37,0% y 32,0% respectivamente. El 74,0% de las muestras positivas para VPH presentaron infecciones múltiples, siendo más frecuente la coinfección mixta (35,70%) con los genotipos de VPH-6/18 de bajo y alto riesgo oncogénico, 21,40% con los genotipos 6/11/18 y 6/11, cada una. Seguido de 14,30% de las muestras que presentaron infección con VPH-6/11/16/18 y 7,10% con los genotipos 11/16 de bajo y alto riesgo oncogénico. Conclusiones. La alta frecuencia de infección con VPH de alto riesgo oncogénico y la presencia de múltiples genotipos observada en la cavidad bucal de individuos VIH positivos, que no presentaron lesiones compatibles con esta infección en el examen extra e intrabucal, indica que los métodos moleculares de diagnóstico son importantes en la detección de infecciones subclínicas y latentes, lo que puede permitir un mejor seguimiento y manejo más oportuno de estos pacientes con mayor riesgo de desarrollar neoplasias malignas en la cavidad bucal.
Objective. Perform human papilomavirus (HPV) detection and typing in the oral cavity in a group of HIV positive patients, treated at the Center for Care of Patients with Infectious Diseases (CAPEI) of the Faculty of Dentistry-Central University of Venezuela. Methods. Thirty-one oral swabs from HIV-positive patients were evaluated to detect HPV infection using the INNO-LiPA Reverse Hybridization System that detects 28 HPV genotypes of high and low oncogenic risk. Results. The 61.0% of the evaluated samples had an HPV infection. The low risk genotype 6 was the most frequent (73.68%), followed by genotypes 18, 11 and 16 with 63.16%, 37.0%, and 32.0%, respectively. Seventy-four percent of HPV positive samples had multiple infections, being the more frequent the mixed coinfection (35.70%), with HPV genotypes 6/18 of low and high oncogenic risk, 21.40% with genotypes 11/6/18 and 6/11, each one, followed by 14.30% of the samples presented infection with HPV-6/11/16/18 and 7.10% with the 11/16 genotypes of low and high oncogenic risk. Conclusions. The high frequency of infection with high oncogenic risk HPV types and the presence of multiple genotypes observed in the oral cavity of HIV positive patients, who did not present lesions compatible with this infection in the extra and intraoral examination, indicates that molecular diagnostic methods are important in the detection of subclinical and latent infections, which may allow better follow-up and more timely management of these patients with a higher risk of developing malignant lesions in the oral cavity
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La microbiota intestinal representa una reserva potencial de organismos resistentes a los antimicrobianos, y el sitio donde los genes de resistencia pueden ser transferidos desde la microbiota comensal a los microorganismos virulentos. En este trabajo se caracterizaron los perfiles fenotípicos de resistencia a diversos agentes antimicrobianos, en aislados de Escherichia coli, obtenidos de niños sanos, menores de 5 años de edad, y la capacidad de transmisibilidad de esos determinantes de resistencia, mediante ensayos de conjugación. Los aislados de E. coli se obtuvieron partir de coprocultivos de niños sanos mediante el uso de placas de Mc Conkey suplementadas con ampicilina y se les determinó el perfil de resistencia a diversos antibióticos, para luego realizar ensayos de conjugación. A partir de 90 coprocultivos, fueron aisladas 33 cepas de E. coli resistentes a algún antibiótico, presentándose un 66,6% del total de las cepas resistentes en al menos dos antibióticos. Luego de los ensayos de conjugación, se encontró que un 47,4% de las cepas presenta plásmidos conjugativos, transfiriendo marcadores de resistencia. Los patrones generados por enzimas de restricción fueron distintos entre ellos. Estos resultados nos permiten sugerir que estos elementos extracromosomales sean los responsables de la rápida diseminación de la resistencia a los antimicrobianos en la población bacteriana de niños sanos.
Gastrointestinal microbiota represents the potential reserve of antimicrobial-resistant organisms, and the site where resistance genes can be transferred from the commensally microbiota to virulent microorganisms. In this work we characterized the phenotypic resistance profiles to various antimicrobial agents in strains of Escherichia coli isolated from healthy children, less than 5 years of age, and the ability of these determinants of resistance to be mobilized by conjugation. The isolation of E. coli strains from stool culture from healthy children was made through the use of Mc Conkey media supplemented with ampicillin. The profile of resistance to various antibiotics was determined and then conjugation was carried out. From 90-stool culture 33 strains of E. coli resistant to some antibiotic were isolated, 63.6% of bacteria were resistant to -at least- two antibiotic. It have be demonstrated that 47.4% of the isolates harbored conjugative plasmids, which can mobilize markers of resistance. Restriction profiles analysis showed that all patterns were different. These results allow us to suggest that these extracromosomals elements are responsible for the rapid spread of resistance to antimicrobials in the bacterial population of healthy children.
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Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Plasmídeos , Escherichia coli , Anti-Infecciosos , Antibacterianos , Saúde PúblicaRESUMO
Objetivo: Evaluar el efecto antibacteriano in vitro de los extractos de Psidium guajava L (P. guajava) y Psidium acutangulum Mart. ex DC (P. acutangulum) sobre cepas aisladas de Streptococcus mutans (S. mutans) y la cepa control ATCC 25175. Métodos: Los extractos se obtuvieron de frutos sanos y frescos de guayaba en su estado verde y maduro de las especies mencionadas. La identificación de S. mutans a partir de muestras de pacientes con caries cavitadas (código 5 según ICDAS) y de la cepa control se realizó mediante la siembra en agar Mitis Salivarius, en condiciones de anaerobiosis, a 37 ºC, durante 48 horas, observándose colonias azules, rugosas, y las pruebas de susceptibilidad se realiza-ron mediante el método de difusión en disco con los extractos obtenidos. Resultados:S. mutans fue sensible al extracto de las cáscaras de P. guajava en estadio verde, tanto para la cepa control, como para la cepa del paciente, observándose el mayor halo para S. mutansATCC 25175, reportándose un porcentaje de inhibición de 43,8%. Conclusiones: Los extractos de las cáscaras de P. acutangulum y P. guajava tienen efecto antibacteriano sobre S. mutans, representando una opción alternativa frente a este microorganismo, siendo un posible producto complementario a la prevención del desarrollo de la caries dental. Palabras clave: Antibacterianos; Caries dental; Extractos vegetales; Psidium; Streptococcus mutans.
Objective: To evaluate the in vitro antibacterial effect of Psidium guajava L.(P. guajava)and Psidium acutangulum Mart. ex DC (P. acutangulum) extracts on isolated strains of Streptococcus mutans and control strain ATCC 25175. Methods: The extracts were obtained from healthy and fresh guava fruits in their green and mature state of the mentioned species. The identification of S. mutans from samples of patients with cavitated caries lesions (code 5, ICDAS) and from the control strain was carried out on Mitis Salivarius agar, under conditions of anaerobiosis, at 37 °C, for 48 hours, observing blue, rough colonies, and susceptibility tests were carried out using the disc diffusion method with the extracts obtained. Results:S. mutans was sensitive to the P. guajava extract, both for the control strain and for the patient strain, observing the highest inhibition halo for S. mutans ATCC 25175, reporting 43.8% of inhibition. Conclusions: The extracts of the P. acutangulum and P. guajava husks have antibacterial effect on S. mutans, representing an alternative option against this microorganism, being a possible complementary product to the prevention of the development of dental caries. Keywords: Anti-bacterial agents; Dental caries; Plant extracts; Psidium; Streptococcus mutans.
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El cáncer de cuello uterino, es el segundo más frecuente en mujeres a nivel mundial; la infección por Virus de Papiloma Humano (VPH) de alto riesgo oncogénico, es el principal factor etiológico de esta malignidad. La identificación viral se logra mediante métodos moleculares sensibles y específicos como la reacción en cadena de la polimerasa (PCR), que generalmente utiliza hisopados cervicales o biopsias como material biológico. Debido a las complicaciones e incomodidad que implica la toma de estas muestras, se realizan estudios en otras más accesibles como la orina. Por lo que se realizó la detección y tipificación de VPH en muestras de hisopados endocervicales y de orina, se compararon los resultados obtenidos y se evaluó la efectividad del uso de esta última. La extracción del material genético se realizó con el estuche comercial AXYGEN. Para la detección y la tipificación viral se empleó la técnica de PCR en tiempo final. La positividad para VPH fue 68,6% en los hisopados cervicales y 62,9% en las muestras de orina de, valores similares y comparables a estudios previos. Así mismo, la concordancia obtenida entre los resultados de las muestras empleadas respecto a los tipos virales identificados fue moderada (k=0,609), encontrándose además valores altos de sensibilidad y especificidad de 83,3% y de 81,8% respectivamente al usar muestras de orina. Estos resultados apuntan a la posibilidad de desarrollar un diagnóstico efectivo para VPH empleando muestras de orina, ya que reducirían la intervención de personal adiestrado para su toma, costos y la incomodidad para las pacientes.
Cervical cancer is the second most common cancer in women worldwide. Infection with high oncogenic risk Human Papillomavirus (HPV) is the main etiological factor of this malignancy. Viral identification is achieved by sensitive and specific molecular methods, such as polymerase chain reaction (PCR), which are generally used on cervical biopsies or swabs of biological material. Because of the complications and discomfort that taking these samples implies, studies are conducted with other samples obtained from less invasive methods, such as urine. Accordingly, detection and genotyping of HPV in endocervical swabs and urine were performed to compare results and to evaluate the effectiveness of using the latter samples. The genetic material was obtaining using the commercial kit Axygen. For viral detection and typing the conventional PCR technique was used. Positivity for HPV in cervical swabs was 68.6% and 62.9% in urine samples, similar values and comparable to previous studies. Likewise, the concordance obtained between the results of the samples used with respect to the identified viral types was moderate (k = 0.609), with high values of sensitivity and specificity of 83.3% and 81.8%, respectively, when urine samples were used. These results point to the possibility of developing an effective diagnosis for HPV using urine samples, because it would reduce the intervention of trained personnel, cost and discomfort for the patients.
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Objetivo: Detección y tipificación de virus de papiloma humano en muestras de niños cuyas madres tienen historia asociada al virus. Métodos: Estudio transversal y descriptivo. Se procesaron 66 hisopados perianales de niños con un promedio de edad de 18 meses atendidos en el Servicio de Dermatología del Hospital Universitario de Caracas. La detección viral se realizó mediante PCR con iniciadores genéricos MY11 y MY09; la tipificación de las muestras positivas en la detección se llevó a cabo mediante PCR múltiple. Resultados: Se obtuvo un porcentaje de positividad de 54,5 % y se identificó VPH de bajo riesgo oncogénico en 47,2 %, ADN viral de alto riesgo en 13,88 % e infecciones mixtas con tipos de alto y bajo riesgo oncogénico en 5,55 % de las muestras positivas. El 33,33 % de estas muestras no pudo ser tipificado con la metodología utilizada. Conclusiones: Aunque no se tienen datos del tipo viral en las madres para hacer comparaciones con los tipos identificados en los niños, estos resultados ponen en evidencia la posible transmisión vertical del VPH, considerando los antecedentes maternos, la corta edad de los niños y que la condición de abuso sexual fue descartada. Es recomendable hacer el seguimiento de la población estudiada con la incorporación de la evaluación de muestras obtenidas de los padres.
Objective: Detection and typing of Human Papillomavirus in samples of children whose mothers have a history associated with the virus. Methods: Transversal and descriptive study. Perianal swabs of 66 children with an average age of 18 months treated in the Service of Dermatology, University Hospital of Caracas, were processed. Viral detection was performed by PCR with MY11 and MY09 generic primers; typing of positive samples was performed by multiplex PCR. Results: A positive percentage of 54.5 % was obtained and low oncogenic risk HPV identified in 47.2 %, high-risk viral DNA in 13.88 % and mixed infections with types of high and low oncogenic risk in 5.55 % of the positive samples. 33.33 % of these samples could not be typed with the used methodology. Conclusions: Although the viral type is unknown in mothers to make comparisons with the types identified in children, these results highlight the possible vertical transmission of HPV, considering maternal history, the young age of the children and that the condition of sexual abuse was ruled out. It is recommended to monitor the studied population including the evaluation of samples obtained from the parents.
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En el presente trabajo se llevó a cabo la extracción de ADN de biopsias cervicales con informe citológico de lesión intraepitelial cervical, incluidas en bloques de parafina, utilizando el QIAamp DNA mini kit (QIAGEN, Alemania) y la detección del Virus de Papiloma Humano (VPH). En el procedimiento original se eliminó la incubación en xilol, reduciendo los lavados del material biológico; la calidad de los ADNs extraídos fue probada mediante PCR para la detección del gen de la β-globina y del VPH, obteniéndose 84,3% y 28,1% de positividad, respectivamente. Estos resultados fueron comparables a los de otros trabajos similares y evidencian la obtención de ADN celular amplificable por PCR a partir de muestras parafinadas, que pudo ser utilizado eficientemente en procedimientos moleculares, eliminando la toxicidad del xilol y disminuyendo la manipulación del material biológico al reducir los lavados.
In the present study, DNA from cervical biopsies with a cytological report of intraepithelial cervical lesion and embedded in paraffin blocks was extracted using the QIAamp DNA mini kit (QIAGEN, Germany), and the Human Papyloma Virus (HPV) was detected. In the original procedure, the xylene incubation was eliminated, therefore reducing the washes of the biological material; the quality of the DNA extracted was tested by PCR for detecting the β-globine gene and HPV, with 84.3% and 28.1% positivity, respectively. These results were comparable to those of other similar studies, and they demonstrate that it is possible to obtain PCR amplifiable cellular DNA from paraffin embedded samples which can be used efficiently for molecular procedures, eliminating xylene toxicity, and decreasing the manipulation of the biological material by reducing washes.