RESUMO
BACKGROUND: The main objective of this study was to estimate the prevalence of human papillomavirus-DNA (HPV-DNA) in the saliva of sexually active women with HPV-related cervical intraepithelial neoplasias (CIN) and compare the findings with a healthy control group. The secondary objectives were: 1) to determine the concordance between genital and oral HPV types in sexually active women with HPV-related CIN; 2) to analyze whether sexual habits influence the presence of HPV-related CIN; 3) to determine whether sexual habits influence the presence of oral HPV. MATERIAL AND METHODS: Saliva samples were collected from 100 sexually active women, 50 with HPV-related CIN and 50 healthy subjects presenting normal cytology. PCR assay was used to detect HPV-DNA. RESULTS: The prevalence of oral HPV infection in saliva samples was 14% in women with HPV-related CIN, while in the healthy group it was 12%, without statistically significant difference (p=0.766). As for the concordance between genital and oral HPV types in women with HPV-related CIN, concordance was only observed for HPV-16, whereby among 22 women with genital HPV-16, only one (4.54%) also presented oral HPV-16. Regarding the possible influence of sexual habits on the presence of cervical pathology and presence of oral HPV, it was found that marital status, age at first intercourse, number of lifetime sexual partners, and condom use are related with the presence of cervical pathology (p<0.001; p=0.017; p=0.002; and p<0.001, respectively); condom use was also found to be related to the presence of oral HPV (p<0.001). CONCLUSIONS: The prevalence of HPV-DNA in the saliva of sexually active women with HPV-related CIN is similar to healthy women. The concordance between genital and oral HPV types is low. Both the presence of cervical pathology and the presence of oral HPV are related to sexual habits. Wider sample size is required to confirm this results.
Assuntos
Papillomaviridae , Infecções por Papillomavirus , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Feminino , Humanos , Prevalência , Fatores de Risco , SalivaRESUMO
Aunque con efectividad probada, las técnicas de ablación por radiofrecuencia y microondas presentan un elevado índice de respuestas parciales. Es imprescindible contar con estudios diagnósticos que se anticipen a los cambios morfológicos para una detección más temprana del tejido tumoral residual viable o de recurrencias locales para determinar los pacientes que serán beneficiados de un nuevo tratamiento. Determinamos mediante nuestro estudio la rentabilidad diagnóstica de los estudios de PET/CT basal y de seguimiento y el tiempo adecuado entre estos y la intervención por ablación. Incluimos 7 pacientes con lesión tumoral única con un total de 8 ablaciones. Hemos realizado estudios CT y PET/CT basales y de seguimiento tras ablación. Los tiempos medios entre estudios PET basales y de seguimiento y la terapia ablativa fueron 1,8 y 3,4 meses respectivamente. Las cuentas medias en actividades metabólicas de los PET basales y de seguimiento han sido de 7,6 y 4,3g/ml de SUVmax respectivamente. La técnica de Dual Time Point ayudó en 3 casos a identificar tejido viable tras ablación. Los estudios de seguimiento PET/CT han condicionado las diversas estrategias terapéuticas adoptadas por los oncólogos clínicos. El alto rendimiento del estudio PET/CT incluyendo la técnica de Dual Time Point puede plantearse como estudio de sustitución de los CT con CIV basales y de seguimiento previo y posterior al tratamiento con ARF o AMO logrando reducir de manera considerable la exposición a altas cifras de radiación. Proponemos realizar el primer estudio PET/CT de seguimiento a los 3 meses de realizada la ARF o AMO(AU)
Although they have proven effectiveness, radiofrequency and microwave ablation techniques have a high rate of partial responses. Diagnostic studies that anticipate the changes in morphology are essential for earlier detection of residual viable tumor tissue or local recurrences to identify patients who will benefit from a new treatment. Our study has determined the diagnostic yield of PET/CT studies at baseline and follow-up and adequate time between them and the ablation intervention. Seven patients with single tumor lesion with a total of 8 ablations were included. CT and PET/CT studies were performed at baseline and follow-up after ablation. Average times between PET studies at baseline and follow-up and the ablative therapy were 1.8 and 3.4 months, respectively. Mean scores in metabolic activities of the PET at baseline and follow-up were 7.6 and 4.3g/ml of SUVmax, respectively. The Dual Time Point technique helped to identify viable tissue after ablation in 3 cases. Follow-up PET/CT studies have conditioned the various treatment strategies adopted by clinical oncologists. The high yield of the PET/CT study including the Dual Time Point technique may be considered as a study replacement of initial and follow-up Contrast-Enhanced CT before and after treatment with RFA and AMO, this achieving considerable reduction in the exposure to high radiation levels. We propose conducting the first PET/CT follow-up study at 3 months of the RFA and AMO(AU)