ABSTRACT
The influence of different infectious agents and their association with human papillomavirus (HPV) in cervical carcinogenesis have not been completely elucidated. This study describes the association between cytological changes in cervical epithelium and the detection of the most relevant aetiological agents of sexually transmitted diseases. Samples collected from 169 patients were evaluated by conventional cytology followed by molecular analysis to detect HPV DNA, Chlamydia trachomatis, herpes simplex virus 1 and 2,Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, andTreponema pallidum, besides genotyping for most common high-risk HPV. An association between cytological lesions and different behavioural habits such as smoking and sedentariness was observed. Intraepithelial lesions were also associated with HPV and C. trachomatis detection. An association was also found between both simple and multiple genotype infection and cytological changes. The investigation of HPV and C. trachomatisproved its importance and may be considered in the future for including in screening programs, since these factors are linked to the early diagnosis of patients with precursor lesions of cervical cancer.
Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Cervix Uteri/microbiology , Chlamydia trachomatis/isolation & purification , DNA, Viral/isolation & purification , Papillomaviridae/isolation & purification , Squamous Intraepithelial Lesions of the Cervix/microbiology , Uterine Cervical Neoplasms/prevention & control , Carcinogenesis , Coinfection , Cross-Sectional Studies , Cytopathogenic Effect, Viral , Cervix Uteri/pathology , Chlamydia Infections/complications , Chlamydia Infections/epidemiology , Early Detection of Cancer/methods , Epithelium/virology , Genotype , Genotyping Techniques , Herpesvirus 1, Human/isolation & purification , /isolation & purification , Molecular Typing , Mycoplasma genitalium/isolation & purification , Neisseria gonorrhoeae/isolation & purification , Papillomaviridae/classification , Papillomavirus Infections/complications , Papillomavirus Infections/epidemiology , Risk Factors , Treponema pallidum/isolation & purification , Trichomonas vaginalis/isolation & purification , Uterine Cervical Neoplasms/microbiologyABSTRACT
CONTEXT: Many factors like exposure to UV radiation, climatic conditions, genetic predisposition, immunological state and, more recently, the presence of HPV have been implicated in the genesis of some lesions of the conjunctiva, especially the carcinoma. OBJECTIVE: To evaluate the presence of HPV DNA in acquired lesions of the conjunctiva and in normal mucosa. TYPE OF STUDY: Cross-sectional study. SETTING: A public university referral center (the Ophthalmology Service of the A.C. Camargo Hospital - A. Prudente Foundation, Sao Paulo). PARTICIPANTS: Thirty patients with acquired lesions of the conjunctiva and 60 matched controls (by age and sex) were evaluated in this study, from June 1993 to March 1995. PROCEDURES: The detection of HPV DNA in the normal conjunctiva and in acquired lesions was done by the PCR technique and dot blot hybridization. The material was collected by scraping the normal mucosa and the surface of the lesions. A fragment of fresh frozen tissue and paraffin embedded specimens of each lesion were also included. MAIN MEASUREMENTS: The association between the HPV infection and the presence or absence of conjunctival lesions. RESULTS: Sequences of HPV DNA were detected in 4 of the 31 lesions evaluated (12.9 percent) and in the healthy mucosa of one individual of the control group (1.6 percent). HPV type 16 was detected in 2 carcinomas and in the normal mucosa of one individual of the control group. HPV type 11 was demonstrated in 2 papillomas of one patient with lesions in both eyes. CONCLUSIONS: The low frequency of HPV DNA found in the lesions of this sample and the detection of the viral genome in the normal mucosa indicate that there is a weak possibility of association between HPV infection and the carcinoma of the conjunctiva