RESUMO
Besides HPV infection, the progression to cervical cancer also depends on the host immune response. HLA-G molecules are involved in the inhibition of cell-mediated immune responses and may permit the development of an infection in the female cervical tract. The aim of this study was to explore the possible influence of the two HLA-G polymorphisms located on the 3'UTR on the susceptibility to cervical cancer and risk factors in Brazilian patients. Polymorphism analysis (14 bp In/Del and +3142C/G) was performed by PCR. A total of 105 cervical samples were tested, 50 without lesions and 55 with lesions; 22 with high grade (HSIL) and 33 with invasive cancer (ICC). The polymorphisms (∗)Del/Del was associated with a decreased risk of developing ICC in smokers and (∗)In and (∗)In/In were associated with an increased risk of HSIL and a higher risk of ICC in smokers. The genotype (∗)In/Del was associated with the increased risk of HSIL only among women with a family history of cancer. The haplotypes (∗)In/G and (∗)Del/G were associated with increased and decreased risk of HSIL and cervical cancer, respectively. In conclusion, the 3'UTR of HLA-G is associated with an increased risk of developing cervical cancer, especially in smokers.
Assuntos
Regiões 3' não Traduzidas , Antígenos HLA-G/genética , Polimorfismo Genético , Displasia do Colo do Útero/genética , Neoplasias do Colo do Útero/genética , Neoplasias Vaginais/genética , Adulto , Idoso , Análise Mutacional de DNA , Feminino , Haplótipos , Hereditariedade , Humanos , Pessoa de Meia-Idade , Mutação , Gradação de Tumores , Fatores de Risco , Fumar , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Neoplasias Vaginais/diagnóstico , Neoplasias Vaginais/patologia , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/patologiaRESUMO
OBJECTIVE: To assess cervical intraepithelial neoplasia (CIN) incidence in HIV-positive women and the risk factors for these lesions. METHODS: A retrospective and longitudinal cohort study was conducted from June 13, 1997, to December 18, 2009. At the first visit, the 348 participants had a normal cytologic finding but a negative Schiller test result, or an abnormal cytologic finding but no histologic diagnosis of CIN. Infection with HPV was detected by polymerase chain reaction. The main outcome measure was CIN incidence. RESULTS: During a mean follow-up of 40 months, 47 women (13.5%) developed CIN, for an incidence of 4.1 cases per 100 person-years of follow-up. The HPV prevalence was 68.1%, 42 women (89.4%) developed CIN 1, and no invasive cervical cancers were identified. On multivariate analysis, women younger than 19 years at first sexual intercourse (RR, 2.6; 95% CI, 1.24-5.35) and women who had never used antiretrovirals or used them only during pregnancy (RR, 2.3; 95% CI, 1.31-4.19) were at higher risk for CIN. CONCLUSION: The CIN incidence was low despite the high HPV prevalence. Being younger than 19 years at first sexual intercourse and not using antiretroviral medications were found to be the main risk factors for CIN.