Dados do Resumo

Título

Frequency of HPV 16 and 18 in patients who underwent excision of the transformation zone (ZT).

Introdução

High-grade cervical intraepithelial neoplasia (CIN) is a premalignant lesion caused by persistent infection with high-risk HPV (hr-HPV), mainly genotypes 16 and 18. Treatment consists of excision of the cervical transformation zone, followed by cytopathological follow-up at 6 and 12 months. Histological changes after the procedure indicate the presence of hr-HPV. Molecular biology has greater sensitivity in detecting hr-HPV, making it possible to identify the risk of lesions recurring.

Objetivo

To describe the frequency of the HPV 16/18 genotype in patients undergoing excision of the transformation zone of the uterine cervix at the Amazonas State Oncology Control Center Foundation (FCecon) and compare it with cytopathology. To describe the clinical and sociodemographic profile.

Métodos

This is a descriptive observational study, approved by FCecon Research Ethics Committee under CAAE number 59113422.4.0000.0004 and opinion 5.651272, which included women who had undergone electrosurgical loop excision (LEEP). The participants were aged ≥ 18 years, with compromised surgical margins on the histopathology report, and with no history of chemotherapy or radiotherapy. After signing an informed consent form, epidemiological, sociodemographic and clinical data were obtained. The endocervical brush was collected after preparation of the slide and sent to FCecon molecular biology laboratory. HR-HPV genotyping was carried out by qPCR, targeting the E7 protein of HPV 16 and 18. Samples negative for HPV16/18 were submitted to conventional PCR using PGMY09/11 primers to detect the presence of HPV. The quality and viability of the samples were checked using the human β-globin gene, ensuring the accuracy of the results.

Resultados

The study included 54 women at FCecon gynecology department. With regard to sociodemographic characteristics, 50 (92.6%) of the participants declared themselves to be brown, 3 (5.6%) and 1 (1.9%) white and black, respectively. With regard to behavioral data, 57% started sexual activity between the ages of 15 and 17, 59% used condoms occasionally and 42% had 3 to 6 children. All the samples were genotyped for HPV 18, with a frequency of 9.3%. For HPV 16, the frequency was 77.8% in the samples analyzed. Compared to the cytopathology results, 50% of the samples were negative for malignancy and positive for HPV 16 and 3.7% were positive for HPV 18. A prevalence of HPV 16 was observed in 20.4% of the cytological alterations, with ASC-US and ASC-H being the most recurrent. The presence of both genotypes was detected in 5.6% of patients.

Conclusões

The study revealed a high prevalence of HPV 16 (77.8%), a low prevalence of HPV 18 (9.3%) and co-infection with HPV 16-18 (5.6%) among women undergoing cervical excision at FCecon. Molecular tests showed greater sensitivity for detecting hr-HPV, even in cases with negative cytopathology for malignancy. The inclusion of DNA-HPV testing in post-treatment can more accurately assess the risk of recurrence for CIN, enabling adjustments to be made to follow-up protocols at FCecon.

Financiador do resumo

FAPEAM – PAIC Program 23/24; EDITAL N. 002/2021 - AMAZÔNIDAS PROGRAM; RESOLUTION N. 002/2008, 007/2018, and 005/2019 - PRÓ-ESTADO GENOMIC HEALTH MONITORING NETWORK: OPTIMIZATION OF ASSISTANCE AND RESEARCH IN THE AMAZON STATE – REGESAM.

Palavras Chave

Loop electrosurgical excision (LEEP); High risk hpv (hr-HPV); cervical intraepithelial neoplasia (CIN)