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1.
Sci Rep ; 8(1): 15319, 2018 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-30333560

RESUMO

Genetic epidemiological studies show that genetic factors contribute significantly to cervical cancer carcinogenesis. Several genome-wide association studies (GWAS) have revealed novel genetic variants associated with cervical cancer susceptibility. We aim to replicate 4 GWAS-identified single nucleotide polymorphisms (SNPs), which were associated with invasive cervical cancer in Chinese women, in a Taiwanese population. The rs13117307 C/T, rs8067378 A/G, rs4282438 G/T, and rs9277952 A/G SNPs were genotyped in 507 women with cervical squamous cell carcinoma (CSCC) and 432 age/sex matched healthy controls by using TaqMan PCR Assay. Human papillomavirus (HPV) DNA test and typing were performed in CSCC patients. Only the rs4282438 SNP was found to be significantly associated (G allele, odds ratio [OR] = 0.67, P = 1.5 × 10-5). This protective association remained in HPV-16 positive CSCC subgroup (G allele, OR = 0.60, P = 1.2 × 10-5). In conclusion, our study confirms the association of rs4282438 SNP with CSCC in a Taiwanese population. However, larger sample sets of other ethnic groups are required to confirm these findings.


Assuntos
Carcinoma de Células Escamosas/genética , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Neoplasias do Colo do Útero/genética , Adulto , Povo Asiático/genética , Estudos de Casos e Controles , Feminino , Estudos de Associação Genética , Humanos , Pessoa de Meia-Idade , Taiwan
2.
Oncotarget ; 8(6): 10085-10090, 2017 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-28036301

RESUMO

Host immunogenetic background plays an important role in human papillomavirus (HPV) infection and cervical cancer development. Inositol 1,4,5-triphosphate receptor type 3 (ITPR3) is essential for both immune activation and cancer pathogenesis. We aim to investigate if ITPR3 genetic polymorphisms are associated with the risk of cervical cancer in Taiwanese women. ITPR3 rs3748079 A/G and rs2229634 C/T polymorphisms were genotyped in a hospital-based study of 462 women with cervical squamous cell carcinoma (CSCC) and 921 age-matched healthy control women. The presence and genotypes of HPV in CSCC was determined. No significant association of individual ITPR3 variants were found among controls, CSCC, and HPV-16 positive CSCC. However, we found a significant association of haplotype AT between CSCC and controls (OR = 2.28, 95% CI 1.31-3.97, P = 2.83 × 10-3) and the OR increased further in CSCC patients infected with HPV-16 (OR = 2.89, 95% CI 1.55-5.37, P = 4.54 × 10-4). The linkage disequilibrium analysis demonstrated that ITPR3 association with CSCC was independent of HLA-DRB1 alleles. In conclusion, these findings suggest that AT haplotype in the ITPR3 gene may serve as a potential marker for genetic susceptibility to CSCC.


Assuntos
Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/genética , Haplótipos , Receptores de Inositol 1,4,5-Trifosfato/genética , Polimorfismo de Nucleotídeo Único , Neoplasias do Colo do Útero/genética , Adulto , Idoso , Povo Asiático/genética , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/etnologia , Carcinoma de Células Escamosas/virologia , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Feminino , Frequência do Gene , Estudos de Associação Genética , Predisposição Genética para Doença , Cadeias HLA-DRB1/genética , Heterozigoto , Homozigoto , Papillomavirus Humano 16/patogenicidade , Humanos , Desequilíbrio de Ligação , Pessoa de Meia-Idade , Razão de Chances , Infecções por Papillomavirus/virologia , Fenótipo , Medição de Risco , Fatores de Risco , Taiwan , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/etnologia , Neoplasias do Colo do Útero/virologia
3.
Oncotarget ; 7(50): 82798-82803, 2016 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-27779103

RESUMO

Human papillomavirus (HPV) infection and the fate of HPV infected cervical epithelial cells are strictly associated with cervical cancer development. P2X7 receptor has been implicated in both the regulation of immune responses and apoptosis of cervical cancer cells. The study aims to investigate if polymorphisms in the P2RX7 gene are associated with the risk of cervical cancer in Taiwanese women. P2RX7 253 T/C, 835 G/A, and 1513 A/C loss-of-function polymorphisms were genotyped in a hospital-based study of 507 women with cervical squamous cell carcinoma (CSCC) and 1619 age-matched healthy control women. The presence and genotypes of HPV in CSCC was determined. The frequency of 253 C/C genotype was found to increase significantly in patients with HPV-16 positive CSCC compared with controls (odds ratio = 10.2, 95% confidence interval 1.39-87.8, Pc = 0.03). No significant associations were found for other 2 polymorphisms. Analysis of haplotypes also revealed no significant differences among women with CSCC, those with HPV-16 positive CSCC and controls. In conclusion, inheritance of the C/C genotype at position 253 in the P2RX7 gene may contribute to the risk of HPV-16 associated CSCC in Taiwanese women.


Assuntos
Carcinoma de Células Escamosas/genética , DNA Viral/genética , Papillomavirus Humano 16/genética , Infecções por Papillomavirus/virologia , Polimorfismo de Nucleotídeo Único , Receptores Purinérgicos P2X7/genética , Neoplasias do Colo do Útero/genética , Adulto , Idoso , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/virologia , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Feminino , Frequência do Gene , Predisposição Genética para Doença , Haplótipos , Hereditariedade , Heterozigoto , Homozigoto , Testes de DNA para Papilomavírus Humano , Humanos , Desequilíbrio de Ligação , Pessoa de Meia-Idade , Razão de Chances , Linhagem , Fenótipo , Fatores de Risco , Taiwan , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia
4.
Cancer Immunol Immunother ; 64(9): 1151-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26031576

RESUMO

Cervical cancer is a multifactorial disease, and increasing evidence suggests that host immunogenetic background may contribute to its pathogenesis. Genetic variations in human leukocyte antigen (HLA) genes may alter the efficiency of immune response to human papillomavirus (HPV) antigens and have been implicated in the risk of cervical cancer. We investigated whether polymorphisms in the HLA-DPB1 gene were associated with cervical cancer risk in a Taiwanese population. HLA-DPB1 alleles and +550 G/A polymorphism were genotyped in a case-control study of 473 women with cervical squamous cell carcinoma (CSCC) and 676 healthy controls. The presence and genotypes of HPV in CSCC were determined. We found that the DPB1*05:01 and +550 A alleles were associated with decreased and increased risk of CSCC, respectively [odds ratio (OR) = 0.72, Pc = 0.001; OR = 1.25, Pc = 0.03]. In subgroup analysis based on HPV type 16 positivity, significant associations were shown in the DPB1*05:01 and *13:01 alleles (OR = 0.65, Pc = 0.0007; OR = 1.83, Pc = 0.004). Furthermore, the DPB1*05:01-G and *13:01-G haplotypes conferred decreased and increased risk of both CSCC and HPV-16 positive CSCC women, respectively (OR = 0.72, Pc = 0.0009; OR = 0.63, Pc = 0.0004 for DPB1*05:01-G; OR = 1.55, Pc = 0.03; OR = 1.84, Pc = 0.004 for DPB1*13:01-G). A risk haplotype DPB1*02:01-A was also observed in the HPV-16 positive CSCC women (OR = 1.51, Pc = 0.05). These findings suggest that HLA-DPB1 gene is involved in the CSCC development.


Assuntos
Carcinoma de Células Escamosas/genética , Cadeias beta de HLA-DP/genética , Neoplasias do Colo do Útero/genética , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/imunologia , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Cadeias beta de HLA-DP/imunologia , Humanos , Pessoa de Meia-Idade , Polimorfismo Genético , Taiwan/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/imunologia
5.
Eur J Cancer ; 50(2): 469-74, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24262586

RESUMO

BACKGROUND: The mere presence of human papillomavirus (HPV) is not enough for cervical cancer development and immunogenetic background may play an important role. Human leucocyte antigen (HLA)-G acts as a negative regulator of immune responses and its expression in tumour cells may enable them to avoid immune attack. We aim to study if polymorphisms in the HLA-G gene are associated with cervical cancer risk in Taiwanese women. METHODS: +1537 A/C, 14-bp deletion/insertion (Del/Ins), and +3142 G/C polymorphisms were genotyped in a hospital-based study of 317 women with cervical squamous cell carcinoma (CSCC) and 400 healthy control women frequency matched by age. The presence and genotypes of HPV in CSCC were determined. RESULTS: We found the +3142 C/C genotype and C allele were associated with increased risk for CSCC (adjusted odds ratio [OR]=1.78, P=0.004; adjusted OR=1.31, P=0.014, respectively). In subgroup analysis based on HPV type 16 positivity, significant associations with higher adjusted ORs were found in +3142 C/C genotype and C allele (adjusted OR=2.19, P=0.001; adjusted OR=1.48, P=0.003, respectively) and +1537 C/C genotype and C allele frequencies increased significantly (adjusted OR=2.88, P=0.004; adjusted OR=1.69, P=0.0005, respectively). Furthermore, the C-Del-C haplotype conferred increased risk of both CSCC and HPV-16 positive CSCC women (adjusted OR=1.41, P=0.009; adjusted OR=1.94, P=0.0001, respectively). CONCLUSION: These findings suggest that HLA-G gene is involved in the susceptibility to CSCC.


Assuntos
Carcinoma de Células Escamosas/genética , Predisposição Genética para Doença/genética , Antígenos HLA-G/genética , Polimorfismo Genético , Neoplasias do Colo do Útero/genética , Adulto , Idoso , Alelos , Povo Asiático/genética , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/etnologia , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença/etnologia , Genótipo , Humanos , Mutação INDEL , Pessoa de Meia-Idade , Razão de Chances , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/etnologia , Fatores de Risco , Taiwan , Neoplasias do Colo do Útero/complicações , Neoplasias do Colo do Útero/etnologia
6.
Hum Immunol ; 74(7): 882-7, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23603311

RESUMO

Cervical cancer is strongly associated with infection of oncogenic types of human papillomavirus (HPV). However, HPV infection alone is not sufficient for progression to cervical cancer. It is now recognized that host immunogenetic background participates in the control of HPV infection and development of cervical cancer. Interleukin-18 (IL-18) is a multifunctional cytokine that induces interferon-gamma secretion and plays a central role in antitumor immunity. The aim of this study is to determine if potentially functional polymorphisms in IL-18 gene are associated with risk of HPV-induced cervical cancer in Taiwanese women. Pre-Developed TaqMan Allelic Discrimination Assay was used to genotype IL-18 -1297 T/C, -607 C/A, -380 C/G, -137 G/C, and +105 A/C polymorphisms in a hospital-based study of 470 women with cervical squamous cell carcinoma (CSCC) and 722 age-matched healthy control women. The presence and genotypes of HPV in CSCC was determined by PCR. None of the polymorphisms or any haplotype was found to have significant differences in distribution among all subjects with CSCC, those with HPV-16 positive CSCC, and controls. Our results suggest that the IL-18 -1297 T/C, -607 C/A, -380 C/G, -137 G/C, and +105 A/C polymorphisms are not associated with susceptibility to CSCC in Taiwanese women.


Assuntos
Carcinoma de Células Escamosas/genética , Interleucina-18/genética , Papillomaviridae/imunologia , Infecções por Papillomavirus/genética , Neoplasias do Colo do Útero/genética , Adulto , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/imunologia , Análise Mutacional de DNA , Suscetibilidade a Doenças , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/imunologia , Polimorfismo Genético , Risco , Taiwan , Neoplasias do Colo do Útero/etiologia , Neoplasias do Colo do Útero/imunologia
7.
Cancer Immunol Immunother ; 61(11): 2153-9, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22610085

RESUMO

Cervical cancer is caused primarily by infection with oncogenic types of human papillomavirus (HPV). However, HPV infection alone is not sufficient for the progression to cervical cancer. Host immunogenetic factors may involve in the development of this disease. Inositol 1,4,5-trisphosphate 3-kinase C (ITPKC) is recently shown to act as a negative regulator of T-cell activation. We aim to study if polymorphisms in the ITPKC gene are associated with the risk of cervical cancer in Taiwanese women. ITPKC rs28493229 C/G, rs890934 G/T, rs2303723 C/T, and rs10420685 A/G polymorphisms were genotyped in a hospital-based study of 465 women with cervical squamous cell carcinoma (CSCC) and 800 age-matched healthy control women. The presence and genotypes of HPV in CSCC were determined. The frequency of G/G genotype and G allele of the ITPKC rs28493229 polymorphism was significantly higher in patients with CSCC compared with controls (OR = 1.81, 95 % CI 1.20-2.73, P = 0.005, P (c) = 0.02; OR = 1.70, 95 % CI 1.14-2.54, P = 0.008, P (c) = 0.03, respectively). No significant associations were found for other 3 polymorphisms. Haplotype analysis revealed the distribution of haplotype CGTA was significantly reduced in women with CSCC (OR = 0.59, 95 % CI 0.40-0.89, P = 0.01, P (c) = 0.04). In conclusion, we found the G/G genotype and G allele of the ITPKC rs28493229 polymorphism may contribute to the risk of CSCC in Taiwanese women. This finding provides new insights into the mechanisms of immune activation in cervical cancer.


Assuntos
Carcinoma de Células Escamosas/genética , Fosfotransferases (Aceptor do Grupo Álcool)/genética , Polimorfismo Genético , Neoplasias do Colo do Útero/genética , Adulto , Idoso , Carcinoma de Células Escamosas/enzimologia , Carcinoma de Células Escamosas/epidemiologia , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Haplótipos , Humanos , Incidência , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Prevalência , Risco , Taiwan/epidemiologia , Neoplasias do Colo do Útero/enzimologia , Neoplasias do Colo do Útero/epidemiologia
8.
J Clin Gastroenterol ; 44(2): 135-9, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19713864

RESUMO

BACKGROUND AND GOALS: Biliary atresia (BA) is a chronic inflammatory disease of the bile ducts resulting in biliary cirrhosis. Vascular endothelial growth factor (VEGF) has been implicated in cell-mediated inflammatory reactions. We aimed to study the relationship between genetic variations of the VEGF gene and susceptibility to BA using both case-control and family-based methodologies. STUDY: A total of 45 Taiwanese children with BA, 160 ethnically matched healthy controls, and 40 families (consisting of parents, affected children, and unaffected siblings) were studied. Three functional VEGF polymorphisms (-2578 A/C, -634 G/C, and +936 C/T) were assessed by using TaqMan assay. RESULTS: The +936 CC genotype [odds ratio (OR) 3.51, 95% confidence interval 1.54-8.01, P(c)=0.006] and C allele (OR 3.19, 95% confidence interval 1.48-6.90, P(c)=0.004) were significantly associated with increased risk of BA. The association of the +936 C allele with BA was also confirmed in a family-based association study (OR 5.7, chi2=9.8, P(c)=0.005). None of the haplotypes studied significantly influenced the risk to BA in either the case-control or family data sets. CONCLUSIONS: The VEGF +936 C/T polymorphism and particularly the C allele are associated with BA, possibly conferring increased susceptibility to the disease.


Assuntos
Atresia Biliar/genética , Predisposição Genética para Doença , Polimorfismo Genético , Fator A de Crescimento do Endotélio Vascular/genética , Adolescente , Adulto , Alelos , Povo Asiático/genética , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Seguimentos , Variação Genética , Haplótipos , Humanos , Lactente , Recém-Nascido , Masculino , Taiwan , Adulto Jovem
9.
J Clin Immunol ; 28(5): 405-10, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18481160

RESUMO

BACKGROUND: Although some previous studies have reported that genetic and immunological factors play important roles in the pathogenesis of Kawasaki disease (KD), the etiological factors of this enigmatical pediatric disease are still poorly understood. PURPOSE: This study aims to investigate whether polymorphisms of the CD40 ligand (CD40L) gene are associated with KD and the development of coronary artery lesions (CAL) in the Taiwanese children. MATERIALS AND METHODS: The CD40L -3459 A/G and IVS4+121 A/G single nucleotide polymorphisms (SNPs) were genotyped in 167 children with KD and 1,010 ethnically matched healthy controls by TaqMan assay. RESULTS: None of the CD40L polymorphisms was associated with susceptibility or CAL development of KD, and this finding was supported by the haplotype analysis. CONCLUSION: In summary, these results provide little support for specific CD40L SNPs in the susceptibility or CAL development of KD in Taiwanese children. However, it will be necessary to validate or replicate this association in other independent large-size ethnic groups.


Assuntos
Ligante de CD40/genética , Estenose Coronária/genética , Síndrome de Linfonodos Mucocutâneos/genética , Adulto , Povo Asiático , Ligante de CD40/imunologia , Criança , Pré-Escolar , Estenose Coronária/imunologia , Feminino , Predisposição Genética para Doença , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Síndrome de Linfonodos Mucocutâneos/imunologia , Síndrome de Linfonodos Mucocutâneos/fisiopatologia , Polimorfismo de Nucleotídeo Único , Taiwan
10.
J Clin Immunol ; 28(4): 322-8, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18297377

RESUMO

INTRODUCTION: Kawasaki disease (KD) is an acute febrile vasculitis of unknown etiology that mainly occurs in infants and children. Clinical and histopathologic findings suggest that vascular endothelial growth factor (VEGF) is involved in the coronary artery lesions (CALs) development in KD. This study hypothesized that specific VEGF gene polymorphisms and their haplotypes are associated with KD susceptibility and CAL development in Taiwanese children. SUBJECTS AND METHODS: The VEGF -2578 A/C, -634 G/C, and +936 C/T single-nucleotide polymorphisms (SNPs) were genotyped in 156 children with KD and 672 ethnically matched healthy controls using the Pre-Developed TaqMan Allelic Discrimination Assay. RESULTS: No significant differences in genotype, allele, carrier, and haplotype frequencies of the three SNPs were found between healthy controls and children with KD or between patients with and without CAL. CONCLUSION: Our data suggest that VEGF -2578 A/C, -634 G/C, and +936 C/T SNPs do not confer increased susceptibility to KD or to CAL development.


Assuntos
Predisposição Genética para Doença , Síndrome de Linfonodos Mucocutâneos/genética , Polimorfismo de Nucleotídeo Único , Fator A de Crescimento do Endotélio Vascular/genética , Criança , Pré-Escolar , Doença da Artéria Coronariana/genética , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Síndrome de Linfonodos Mucocutâneos/complicações , Reação em Cadeia da Polimerase , Taiwan
11.
Carcinogenesis ; 28(6): 1237-40, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17341658

RESUMO

Human papillomavirus (HPV) is considered to be a necessary but not sufficient cause for cervical cancer. The host immunogenetic background plays an important role in the persistence of HPV infection and subsequent development of cervical cancer. Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is a molecule expressed mainly on activated T cells and is important in the down-regulation of T-cell activation. The aim of this study was to determine if polymorphisms of the CTLA-4 gene are associated with HPV-induced cervical cancer in Taiwanese women. Polymerase chain reaction-restriction fragment length polymorphism was used to genotype -318 C/T, +49 A/G and CT60 A/G polymorphisms in 144 women with cervical squamous cell carcinoma (CSCC) and 378 ethnicity-matched healthy control women. The presence and genotypes of HPV in CSCC were determined by E6-, E7-based nested polymerase chain reaction. The frequency of C/T genotype of -318 C/T polymorphism was significantly higher in patients with HPV-16-positive CSCC compared with controls (odds ratio = 1.99, 95% confidence interval = 1.16-3.42, P(c) = 0.03). No significant associations were found for +49 A/G and CT60 A/G polymorphisms. Analysis of haplotypes, computationally inferred from genotype data, also revealed no significant differences in distribution among all subjects with CSCC, those with HPV-16-positive CSCC and controls. Our results suggest that the -318 C/T variant in the promoter region of the CTLA-4 gene is associated with HPV-16-associated CSCC in Taiwanese women.


Assuntos
Antígenos CD/genética , Antígenos de Diferenciação/genética , Carcinoma de Células Escamosas/etiologia , Predisposição Genética para Doença , Papillomavirus Humano 16/fisiologia , Infecções por Papillomavirus/etiologia , Neoplasias do Colo do Útero/etiologia , Antígenos CD/fisiologia , Antígenos de Diferenciação/fisiologia , Antígeno CTLA-4 , Carcinoma de Células Escamosas/genética , Feminino , Haplótipos , Humanos , Infecções por Papillomavirus/genética , Mutação Puntual , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas , Taiwan , Neoplasias do Colo do Útero/genética
12.
Hum Immunol ; 67(4-5): 331-40, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16720214

RESUMO

Polymorphisms in human leukocyte antigen (HLA) genes have been implicated in the risk for cervical cancer. Association of certain class II HLA alleles with cervical cancer has been documented in various ethnic populations. The implications of such an association, however, are controversial. We analyzed 126 Chinese women with cervical squamous cell carcinoma (CSCC) and 289 healthy controls to test associations of certain HLA-DRB1 alleles. We then performed meta-analyses combining our own experimental data and data from nine other published studies. We found no significant differences in HLA-DRB1 allele frequencies in both CSCC and HPV-16-positive CSCC patients and control subjects. Meta-analysis provided evidence that four allele families (HLA-DRB1*04, *07, *11, and *15) and seven alleles (HLA-DRB1*0403, *0405, *0407, *0701, *1501, *1502, and *1503) were positively associated and two allele families (HLA-DRB1*09 and *13) and four alleles (HLA-DRB1*0901, *1301, *1302, and *1602) were negatively associated with CSCC in all studies or in Caucasian subgroups. In conclusion, our meta-analysis confirms the apparent association between certain HLA-DRB1 allele families and alleles and CSCC, suggesting that oncogenesis in this disease may be related to defects in immunoregulation. Larger studies may be needed, particularly in various ethnic groups, to further substantiate these associations.


Assuntos
Carcinoma de Células Escamosas/genética , Antígenos HLA-DR/genética , Polimorfismo Genético , Neoplasias do Colo do Útero/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/imunologia , China/epidemiologia , Feminino , Frequência do Gene , Cadeias HLA-DRB1 , Humanos , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/imunologia
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