Néoplasies intraépithéliales du col utérin chez la congolaise à Kinshasa : intérêt des biomarqueurs immunohistochimiques

Contexte et objectif.Bien que le cancer du col utérin soit le deuxième cancer plus fréquent chez la femme en Afrique, le recours aux biomarqueurs immunohistochimiques reste exceptionnel en Afrique subsaharienne. La présente étude avait pour objectif de montrer l'apport des biomarqueurs p16 et Ki-67 dans le diagnostic des néoplasies intra-épithéliales du col utérin. Méthodes. C'était une étude rétrospective réalisée dans cinq laboratoires d'Anatomie Pathologique de Kinshasa. Des lames biopsiques ont été relues et reclassées par au moins deux pathologistes indépendants aux Cliniques Universitaires de Kinshasa en suivant la nomenclature de Bethesda/OMS. L'immunomarquage (p16 et Ki-67) a été réalisé avec un contrôle qualité externe en Europe. Résultats. 70 cas ont été inclus. Les 24 cas des néoplasies intra-épithéliales de haut grade (CIN2, CIN3 et CIS) étaient marquées positivement par p16 et Ki-67 alors que celles de bas grade étaient marquées positivement pour 41 cas de CIN1 et négativement pour 5 cas (3 de CIN1 et 2 de CP). Certaines lésions ont été requalifiées. L'immunomarquage était significativement associé au grade des néoplasies pour la p16 (p=0,001) et pour le Ki-67 (p=0,004). Conclusion. P16 et Ki-67 sont des biomarqueurs spécifiques et efficaces pour un diagnostic optimal des néoplasies intra-épithéliales du col utérin

Genetic Diseases and Prenatal Genetic Testing: Knowledge Gaps, Determinants of Uptake and Termination of Pregnancies among Antenatal Clinic Attendees in Lagos, Southwest Nigeria

Background: Though prenatal genetic testing has been shown to have immense benefits, reports suggest it is not routinely done and is unavailable to many pregnant women in Nigeria. Factors associated with prenatal genetic testing as well as ethical aspects of consequent options available need to be assessed if prenatal testing is to be proposed to Nigerian women. Aims: This study evaluated the knowledge of genetic diseases and prenatal genetic testing, willingness to test, attitudes towards testing, use of common tests available as well as willingness to terminate affected pregnancies among antenatal clinic attendees in selected health facilities in an urban local government area (LGA) in Lagos, southwest Nigeria. Materials and Methods: This was a descriptive cross-sectional study. The study participants were 327 pregnant women in any of the three trimesters of pregnancy interviewed with structured questionnaires in two primary and one secondary health facility in the Local Government Area. Collected data was analysed using Epi-Info 7.2 statistical software. Results: Respondents' mean age was 30 years ± 4.22. Majority of the respondents had post-secondary education, were experiencing their first pregnancy, and had no previous pregnancies or relatives with genetic diseases. More than half (69.4%) of the respondents had poor knowledge of genetic diseases. Almost all the respondents (97.6%) had poor knowledge of prenatal genetic testing. Majority of respondents (61.8%) were willing to undergo testing. Only 23.9% of the respondents had good attitude scores. Majority (26.9%) of the participants who had made use of a prenatal screening or diagnostic test had made use of ultrasound and blood test before three months of pregnancy. Only 10.1% of the population stated that they would opt to terminate affected pregnancies. Knowledge of genetic diseases significantly correlated with decision to terminate affected pregnancies. Conclusion: Education and approaches to ensure improved supportive care and treatment for children with genetic diseases should be explored in our environment