Dados do Resumo

Título

Frequency of Co-Infection Between Epstein-Barr Virus (EBV) and Human Papillomavirus (HPV) in Histological Types of Cervical Cancer at a Reference Oncology Hospital in Amazonas

Introdução

Cervical cancer (CC) is one of the leading causes of mortality among women. The state of Amazonas has notably high mortality rates, with persistent high-risk HPV, particularly genotypes 16 and 18, being significant contributing factors to its development. The presence of Epstein-Barr Virus (EBV) has been detected in warts and genital lesions, suggesting that it may act as a cofactor influencing cellular proliferation mechanisms and contributing to HPV-associated carcinogenesis.

Objetivo

Describe the frequency of coinfection between HR-HPV16/18 and EBV in histological types of cervical cancer in women treated at the Fundação Centro de Controle de Oncologia do Estado do Amazonas-FCecon.

Métodos

This is a cross-sectional descriptive observational study approved by the Ethics and Research Committee of FCecon with CAAE Number: 59349816.0.0000.0004 and Opinion: 1.727.786. Participants were ≥ 18 years old, with a diagnosis of squamous cell carcinoma or adenocarcinoma, and had no history of chemotherapy or radiotherapy. After signing the Informed Consent Form, epidemiological, sociodemographic, and clinical data were collected. Three fragments, approximately 3 to 5 mm each, from the core of the lesion were obtained in the surgical center or via biopsy in the gynecology outpatient clinic by the responsible physician, and stored without any preservative at -20°C until analysis. DNA extraction was performed using the Qiagen high-performance kit (QIAamp DNA Mini Kit) and quantified using the NanoDrop 2000c. Real-time PCR (qPCR) was conducted for HPV 16 and 18, generic PCR (PGMY09/11), and for EBV detection, real-time PCR was performed following the Naveca protocol (unpublished data).

Resultados

A total of 33 samples were collected. The most common histological type was squamous cell carcinoma with 66.6% (22/33), followed by adenocarcinoma with 33.3% (11/33). As for staging, 48.4% (15/33) were IB1, 36.6% (12/26) were IIB, and 9% (6/33) were IIIC1. 44% (12/33) of the patients were between 32 and 39 years old. 63.6% (21/33) had never used condoms. HR-HVP16 showed a high prevalence, with 93.3% (31/33) of the samples analyzed. EBV was detected in 54.5% (18/33). Co-infection with HR-HPV16 and EBV was present in 45.4% (15/33) of the samples analyzed, and 6% (2/33) for HR-HPV18. In the squamous cell carcinoma samples, co-infection between HR-HPV16/EBV was observed in 45.5% (15/33). Of these, 42.4% (14/33) are still undergoing gynecological care, 18.2% (6/33) are still undergoing neoadjuvant therapy, 9% (3/33) have relapsed; 18.2% (6/33) have no information in their electronic and physical medical records; 6.1% (2/33) have died, and 6.1% (2/33) have been discharged.

Conclusões

In Amazonas, the high incidence of mortality from cervical cancer highlights the need for improvements in primary health care for women. Despite advances in preventive measures, this cancer continues to be a major public health problem. HR-HPV are etiological agents of CC, EBV may be a cofactor that affects cell proliferation together with HPV, and may promote the development of cervical cancer.

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

Cervical cancer; Human Papillomavirus HPV; Epstein-Barr Virus