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1.
Salud bienestar colect ; 5(1): 18-31, ene.-abr. 2021. ilus, tab, graf
Article in Spanish | LILACS | ID: biblio-1352345

ABSTRACT

INTRODUCCIÓN: Los problemas sanitarios en los pacientes que padecen cáncer cérvico-uterino influyen en la satisfacción personal y evitan una gran adherencia a la terapia médica, y además están relacionados con un número más notable de efectos secundarios y la estancia en la clínica de emergencia junto afecciones depresivas y problemas de ansiedad. OBJETIVO: Identificar la influencia del cáncer cérvico -uterino en las alteraciones en la salud mental de pacientes menores de 25 años en el Ecuador. METODOLOGÍA: La investigación fue de tipo cuantitativo, descriptivo, y de corte transversal. Se utilizaron encuestas de manera virtual dirigida a pacientes menores de 25 años que padecen de cáncer al cuello uterino en diversas Fundaciones que luchan contra el cáncer, contando con una muestra de 178 mujeres, estas se dividieron en 4 categorías: Salud mental, Estrés, Depresión y Total de escalas. RESULTADOS: El porcentaje que se obtuvo de manera general tuvo un rango variado, el 32,9% dio como resultado que la alteración que causa en la mujer es contundente, seguido del 30,6 que su afección en la salud mental es más baja. CONCLUSIÓN: Se concluye afirmando que el cáncer uterino es el segundo cáncer más prevalente en la mujer, el cual influye de manera progresiva en la salud mental, presentando reacciones negativas y percepciones, falta de control en las emociones, consecuentemente aquello debilita el sistema inmunológico previamente comprometido, generando alteraciones en el curso del tratamiento.


INTRODUCTION: Health problems in patients suffering from cervical-uterine cancer influence personal satisfaction and prevent a high adherence to medical therapy, and are also related to a more notable number of side effects and stay in the emergency clinic together depressive conditions and anxiety problems. OBJECTIVE: To identify the influence of cervical cancer -uterine in the alterations in the mental health of patients under 25 years in Ecuador. MATERIALS AND METHODS: The research was quantitative, descriptive, andcross-sectional. Surveys were used in a virtual way directed at patients under 25 years of age who suffer from cervical cancer in various Foundations that fight against cancer, with a sample of 178 women, these were divided into 4 categories: Mental health, Stress, Depression and Total stopovers. RESULTS: The percentage that was obtained in a general way had a varied range, 32.9% gave as a result that the alteration it causes in women is overwhelming, followed by 30.6 that their mental health condition is lower. CONCLUSION: It is concluded by stating that uterine cancer is the second most prevalent cancer in women, which progressively influences mental health, presenting negative reactions and perceptions, lack of control over emotions, consequently that weakens the previously compromised immune system, generating alterations in the course of treatment.


Subject(s)
Humans , Female , Young Adult , Uterine Cervical Neoplasms/psychology , Uterine Cervical Neoplasms/virology , Stress, Psychological/complications , Uterine Cervical Neoplasms/complications , Mental Health/statistics & numerical data , Disease , Epidemiology, Descriptive , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Depression , Alphapapillomavirus/genetics
2.
Rev. bras. educ. méd ; 45(3): e155, 2021. tab, graf
Article in English | LILACS | ID: biblio-1288308

ABSTRACT

Abstract: Introduction: Medical students still have many doubts regarding HPV (Human papillomavirus) and the vaccine against this virus. Objective: The study aimed to assess the University of Brasilia medical students' grasp of knowledge about HPV, its relationship with cancer, and the vaccine against the virus. Methods: A cross-sectional study was undertaken by applying a survey questionnaire on the topics. The evaluation involved 379 respondents, 72.7% of the 521 students from the 1st to the 6th years enrolled in the second semester of 2017. The statistical analyses included differences between means and proportions, effect size measures, and the correlation between the identified indicators. The study was approved by the Ethics Committee in Research on Human Beings of the School of Medicine (1,989,835). Results: The 50-item knowledge score increased progressively with the year attended by the medical students (r= .706, p< .001), and was higher among the sexually-active compared to celibate participants (t = 3.26, df = 275, p = 0.001, d = 0.37), as well as among participants with higher family income compared to those with lower family income (t= 2.91, df= 366, p= .004, d= .35). No significant score differences emerged between participants grouped by gender, sexual behavior, or HPV vaccination status. Furthermore, gender (female; OR= 6.5, p<.001), age range (<24 years; OR= 3.3, p= .001), sexuality (active; OR= 2.7, p= .002), but not overall knowledge were predictors of the wish to be vaccinated among the 297 unvaccinated students. Conclusion: The study revealed a strong correlation of medical students' HPV-related knowledge with medical school year and significantly higher scores among sexually active and higher-income respondents, but there were no essential differences between males and females or between vaccinated and unvaccinated students. Among the latter participants, gender, age, and sexuality, but not knowledge, were the best predictors of the wish to be vaccinated. The findings suggest the need for improving HPV screening and vaccination programs and educational strategies regarding HPV-related diseases.


Resumo: Introdução: Há ainda, entre os estudantes de Medicina, muitas dúvidas com relação ao papilomavírus humano (HPV) e à vacina contra esse vírus. Objetivo: Este estudo teve como objetivo avaliar a compreensão dos estudantes de Medicina da Universidade de Brasília acerca do HPV, da sua relação com o câncer e da vacina contra o vírus. Método: Foi realizado um estudo transversal por meio da aplicação de um questionário teste sobre os temas. A avaliação envolveu 379 respondentes, o que representava 72,7% dos 521 alunos do primeiro ao sexto ano matriculados no segundo semestre de 2017. As análises estatísticas incluíram diferenças entre médias e proporções, medidas de tamanho de efeito e a correlação entre os indicadores identificados. O estudo foi aprovado pelo Comitê de Ética em Pesquisa em Seres Humanos da Faculdade de Medicina (1,989,835). Resultado: A pontuação de conhecimento de 50 itens aumentou progressivamente com o ano do curso médico (r = 0,706, p <0,001) e foi maior entre os participantes sexualmente ativos em comparação com os celibatários (t = 3,26, df = 275, p = 0,001, d = 0,37), e entre os participantes com renda familiar mais alta em comparação com aqueles com renda mais baixa (t = 2,91, df = 366, p = 0,004, d = 0,35). Nenhuma diferença significativa de pontuação foi observada entre os participantes agrupados por gênero, comportamento sexual ou estado de vacinação contra o HPV. Além disso, sexo (feminino; OR = 6,5, p <0,001), faixa etária (<24 anos; OR = 3,3, p = 0,001) e sexualidade (ativo; OR = 2,7, p = 0,002), mas não o conhecimento geral, foram preditores do desejo de vacinação entre 297 alunos não vacinados. Conclusão: O estudo revelou uma forte correlação entre o conhecimento relacionado ao HPV dos estudantes de Medicina e o ano de estudo, e pontuações significativamente mais altas entre os respondentes sexualmente ativos e de renda superior, mas não houve nenhuma diferença essencial entre homens e mulheres ou entre alunos vacinados e não vacinados. Entre estes últimos, gênero, idade, sexualidade, e não o conhecimento foram os melhores preditores do desejo de vacinação. Os achados sugerem a necessidade de aperfeiçoamento em programas de triagem e vacinação para HPV e nas estratégias educacionais referentes às doenças relacionadas ao vírus.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Students, Medical , Uterine Cervical Neoplasms/prevention & control , Health Knowledge, Attitudes, Practice , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines , Sexual Behavior , Socioeconomic Factors , Uterine Cervical Neoplasms/virology , Cross-Sectional Studies , Surveys and Questionnaires
3.
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1142101

ABSTRACT

El Cáncer de Cuello Uterino (CCU) es un problema de Salud pública a nivel mundial. Su indiscutible asociación con el Virus del papiloma humano (HPV) hace necesario su estudio. El objetivo de este trabajo, es conocer la prevalencia de los diferentes genotipos de HPV, en lesiones pre invasoras de alto grado de malignidad (HSIL) y/o cáncer de cuello uterino. Material y Métodos: Todas las Mujeres que fueron derivadas a pol de TGI del H Clínicas entre enero del 2011 y diciembre de 2012, por un PAP sospechoso de lesión y en las que se confirmó luego un HSIL o cáncer cervical fueron tipificadas. Se recabaron datos de edad, tipo de lesión y genotipificación. La extracción de ADN viral se realizó a partir de muestras cervico vaginales conservadas en medio de transporte comercial (Sacace) mediante el kit QIAamp DNA Mini Kit (QIAGEN). Se buscaron 14 genotipos de alto riesgo. Resultados: Se tipificaron 75 pacientes, 19 con CCU y 56 con HSIL. El HPV 16 fue el más prevalente en un 61,5 % para las infecciones únicas y en un casi 100 % para las múltiples y un 60% para el total de las lesiones, seguido en prevalencia por los HPV 31,33 y 45. El HPV 18 fue muy poco prevalente. Conclusiones: En esta muestra, la prevalencia del HPV 16 está acorde con las publicaciones nacionales siendo el más frecuente. El HPV 18 tiene muy baja prevalencia siendo 2 casos en 75, siempre en infecciones múltiples.


Cervical Cancer (CC) is a public health problem worldwide. Its indisputable association with the Human Papilloma Virus (HPV) makes its study necessary. The objective of this work is to know the prevalence of the different HPV genotypes, in pre-invasive high-grade malignant lesions (HSIL) and / or cervical cancer. Material and Methods: All women who were referred to Low genital tract service in the Hospital de Clinicas between January 2011 and December 2012, for a PAP suspected of injury and in which HSIL or cervical cancer was later confirmed were typified. Data on age, type of lesion and genotyping were collected. The viral DNA extraction was carried out from cervico-vaginal samples preserved in commercial transport medium (Sacace) using the QIAamp DNA Mini Kit (QIAGEN). 14 high-risk genotypes were searched. Results: 75 patients were typified, 19 with CCU and 56 with HSIL. HPV 16 was the most prevalent in 61.5% for single infections and almost 100% for multiple infections and 60% for all lesions, followed in prevalence by HPV 31,33 and 45. The HPV 18 was very rare. Conclusions: In this sample, the prevalence of HPV 16 is in accordance with national publications, being the most frequent. HPV 18 has a very low prevalence, being 2 cases in 75, always in multiple infections.


O câncer cervical é um problema de saúde pública em todo o mundo. E um câncer com uma ligação comprovada com o vírus do papiloma humano. O objetivo é conhecer a prevalência dos diferentes genótipos do HPV em mulheres que apresentam neoplasias pré-invasivas de alto grau e câncer de colo do útero, que foram tratadas e diagnosticadas no Hospital de Clínicas entre janeiro de 2011 e dezembro de 2012. Material e Métodos: o estudo foi realizado em 75 pacientes do Hospital de Clinicas, com diagnóstico histológico de Câncer Cervical e lesões intraepiteliais de alto grau para as quais foi realizado o tipageme do HPV alto risco. Resultados: 75 pacientes foram tipificados, 19 com CCU e 56 com HSIL. O HPV 16 foi o mais prevalente em 61,5% para infecções únicas e quase 100% para infecções múltiplas e 60% para todas as lesões, seguido em prevalência pelo HPV 31,33 e 45. O HPV 18 era muito raro. Conclusões: Nesta amostra, a prevalência do HPV 16 está de acordo com as publicações nacionais, sendo a mais frequente. O HPV 18 tem prevalência muito baixa, sendo 2 casos em 75, sempre em infecções múltiplas.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Precancerous Conditions/virology , DNA, Viral/isolation & purification , Uterine Cervical Neoplasms/virology , Alphapapillomavirus/genetics , Uruguay/epidemiology , Epidemiology, Descriptive , Prevalence , Cross-Sectional Studies , Age Distribution
4.
Rev. epidemiol. controle infecç ; 10(1): 72-78, jan.-mar. 2020. ilus
Article in Portuguese | LILACS | ID: biblio-1179203

ABSTRACT

Justificativas e Objetivos: Câncer de colo de útero é considerado um problema de saúde pública mundial. Seu diagnóstico é realizado através do exame citopatológico (EC) e seu desenvolvimento relacionado à infecção pelo papilomavírus humano (HPV). Este estudo objetiva avaliar o perfil de mulheres atendidas em centros de referência em saúde de Porto Alegre, Rio Grande do Sul, assim como a relação de alterações observadas ao EC com presença do HPV. Métodos: Estudo transversal realizado em mulheres atendidas em unidades básicas de saúde e um ambulatório de referência de hospital público terciário, no período de julho de 2014 a janeiro de 2017. Coletaram-se amostras representativas da endo/ectocérvice para realização do EC e investigadas quanto à presença molecular do HPV. Resultados: Foram analisadas 169 mulheres com idade média entre 31 e 40 anos, das quais 125 (74%) informaram que a sexarca ocorreu na faixa de 15-20 anos e 37,9% relatou ter tido de três a cinco parceiros sexuais. Em relação ao EC, 71 (42%) apresentaram resultado negativo para lesão intraepitelial ou malignidade e 98 (58%) alguma anormalidade de células escamosas: 20 (11,8%) atipias; 22 (13%) lesão intraepitelial escamosa de baixo grau e 56 (32,6%) lesão intraepitelial de alto grau (HSIL). Cinquenta (29,6%) apresentaram positividade para HPV, destas 56,4% foram diagnosticadas com HSIL (p<0,01). Conclusão: Os resultados revelam alta frequência de HPV em amostras com alterações citopatológicas, em mulheres jovens e com grau de exposição ao HPV, reforçando a importância do papel da sua identificação precoce na investigação da carcinogênese cervical.(AU)


Background and Objectives: Cervical cancer is considered a worldwide public health problem. Its diagnosis is made through cytopathological examination and its development related to human papillomavirus (HPV) infection. This study aims to evaluate the profile of women treated at reference health centers in Porto Alegre, Rio Grande do Sul, as well as the relation of changes observed to cytopathological examination with the presence of HPV. Methods: This is a cross-sectional study carried out in women treated at basic health units and a referral clinic of a public tertiary hospital, from July 2014 to January 2017. Representative samples of the endo/ectocervix were collected to perform the cytopathological examination and investigated for the molecular presence of HPV. Results: 169 women with mean age between 31 and 40 years were analyzed, of whom 125 (74%) reported that the onset of sexual activity occurred in the 15-20 years age group, and 37.9% reported having had three to five sexual partners. In relation to cytopathological examination, 71 (42%) had a negative result for intraepithelial lesion or malignancy and 98 (58%) some squamous cell abnormality: 20 (11.8%) atypical; 22 (13%) low-grade squamous intraepithelial lesion and 56 (32.6%) high-grade intraepithelial lesion (HSIL). Fifty (29.6%) were positive for HPV, of which 56.4% were diagnosed with HSIL (p < 0.01). Conclusion: The results reveal a high frequency of HPV in samples with cytopathological changes, in young women and with a degree of exposure to HPV, reinforcing the importance of the role of its early identification in the investigation of cervical carcinogenesis.(AU)


Justificación y objetivos: El cáncer de cuello uterino se considera un problema de salud pública en todo el mundo. Su diagnóstico se realiza mediante el examen citopatológico (EC), y su desarrollo está relacionado con la infección por el virus del papiloma humano (VPH). Este estudio objetivó evaluar el perfil de mujeres atendidas en los centros de referencia en salud de Porto Alegre, Rio Grande do Sul (Brasil), así como la relación de las alteraciones observadas en el EC con la presencia del VPH. Métodos: Estudio transversal realizado en las mujeres atendidas por unidades de atención primaria y por una clínica ambulatoria de referencia del hospital público terciario en la ciudad de Porto Alegre, en el período de julio de 2014 a enero de 2017. Se recolectaron muestras representativas de endo/ectocérvice para realizar la CE, las cuales se clasificaron según el sistema Bethesda y se investigaron la presencia molecular del VPH. Resultados: Analizamos 169 mujeres con promedio de edad entre 31 y 40 años, de las cuales 125 (74%) informaron que el sexarche ocurrió en el rango de 15-20 años. La mayoría (37,9%) informó haber tenido de 3 a 5 parejas sexuales; y el 37,3% estaban usando anticonceptivos orales. Con respecto a la EC, 71 (42%) se clasificaron como negativos para lesión intraepitelial o malignidad; y el 98 (58%) tenían alguna anormalidad de células escamosas: 20 (11,8%) de atipias; 22 (13,0%) lesión intraepitelial escamosa de bajo grado y 56 (32,6%) lesión intraepitelial de alto grado (HSIL). La frecuencia de positividad del VPH encontrada fue de 50 (29,6%), de estas un 56,4% fueron diagnosticadas con HSIL (p<0,01). Conclusiones: Estos resultados revelan una alta frecuencia de VPH en muestras con alteraciones citopatológicas presentes en mujeres jóvenes con cierto grado de exposición al VPH, lo que refuerza la importancia de identificarse tempranamente en el análisis de la carcinogénesis cervical.(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Papillomaviridae/isolation & purification , Papillomavirus Infections/pathology , Papillomavirus Infections/epidemiology , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/virology , Cross-Sectional Studies , Age Distribution , Papanicolaou Test , Squamous Intraepithelial Lesions of the Cervix/pathology , Squamous Intraepithelial Lesions of the Cervix/virology
5.
Braz. j. med. biol. res ; 53(2): e9560, 2020.
Article in English | LILACS | ID: biblio-1055496

ABSTRACT

Our aim was to review the major contributions of studies conducted in different Latin American (LA) countries to the field of human papillomavirus (HPV) epidemiology, natural history, risk of disease, and prevention strategies, mainly in the uterine cervix. Although cytological screening is established in several countries in LA, incidence and mortality rates from cervical cancer (CC) are still extremely high. Finally, data from large cohort studies conducted in LA countries provided seminal data to propose primary and secondary prevention modalities: the HPV vaccine has been introduced in the national immunization programs of several LA countries and multiple screening experiences using HPV testing are under evaluation in the region.


Subject(s)
Humans , Male , Female , Papillomaviridae , Uterine Cervical Neoplasms/virology , Papillomavirus Infections/epidemiology , Papillomavirus Vaccines/administration & dosage , Primary Prevention , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/prevention & control , Mass Screening , Papillomavirus Infections/complications , Papillomavirus Infections/prevention & control , Secondary Prevention , Latin America/epidemiology
6.
Rev. Assoc. Med. Bras. (1992) ; 65(5): 625-632, May 2019. tab
Article in English | LILACS | ID: biblio-1012948

ABSTRACT

SUMMARY OBJECTIVE: Human papillomavirus (HPV) is the most prevalent sexually transmitted virus in the world and is associated with an increased risk of cervical cancer. The most effective approach to cervical cancer control continues to be screening through the preventive Papanicolaou test (Pap test). This study analyzes the knowledge of university students of health science programs as well as undergraduate courses in other areas of knowledge on important questions regarding HPV. METHOD: Four hundred and seventy-three university students completed a questionnaire assessing their overall knowledge regarding HPV infection, cervical cancer, and the Pap test. A descriptive analysis is presented, and multivariate analysis using logistic regression identified factors associated with HPV/cervical cancer information. RESULTS: Knowledge was higher for simple HPV-related and Pap test questions but was lower for HPV interrelations with genital warts and cervical cancer. Being from the health science fields and having high income were factors associated with greater knowledge. Only the minority of the participants recognized all the situations that increased the risk of virus infection presented in the questionnaire. CONCLUSIONS: These findings highlight the need for educational campaigns regarding HPV infection, its potential as a cervical cancer agent and the forms of prevention available.


RESUMO OBJETIVO: O papilomavírus humano (HPV) é o vírus sexualmente transmissível mais prevalente no mundo, estando a infecção por este agente associada a um aumento do risco do câncer de colo uterino. A abordagem mais eficaz para o controle desse tipo de câncer continua sendo a triagem por meio do exame preventivo (Papanicolaou). Este estudo analisa o conhecimento de estudantes universitárias de cursos da área da saúde, bem como cursos de graduação de outras áreas do conhecimento com relação a questões importantes sobre o HPV. MÉTODO: Quatrocentas e setenta e três estudantes universitárias responderam a um questionário que avaliava os conhecimentos sobre a infecção pelo HPV, o câncer de colo do útero e o exame preventivo. Após análise descritiva, foi feita a análise multivariada por regressão logística para identificação dos fatores associados à informação sobre o HPV/câncer de colo do útero. RESULTADOS: O conhecimento das universitárias foi maior para questões simples relacionadas ao HPV e ao exame preventivo, mas foi menor para as correlações do HPV com verrugas genitais e com o câncer de colo do útero. Ser aluna da área da saúde e ter alta renda foram fatores associados ao maior conhecimento. Somente uma minoria das participantes reconheceu todas as situações que aumentavam o risco de infecção pelo HPV apresentadas no questionário. CONCLUSÃO: Os resultados evidenciam a necessidade de realização de campanhas educativas sobre a infecção pelo HPV, do seu potencial como agente de câncer do colo uterino e as formas de prevenção disponíveis.


Subject(s)
Humans , Female , Adult , Young Adult , Papillomaviridae , Students/statistics & numerical data , Uterine Cervical Neoplasms/virology , Health Knowledge, Attitudes, Practice , Papillomavirus Infections , Papanicolaou Test , Socioeconomic Factors , Universities , Brazil , Logistic Models , Cross-Sectional Studies , Multivariate Analysis , Surveys and Questionnaires , Risk Factors , Age Factors
7.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 17(1): 6-15, abr. 2019. ilus, tab
Article in Spanish | LILACS, BDNPAR | ID: biblio-1007859

ABSTRACT

En Paraguay la incidencia de cáncer de cuello uterino (CCU) es superior a las observadas en otros países de la región. El agente etiológico asociado al CCU es el virus papiloma humano (VPH), esencialmente tipos de alto riesgo oncogénicos. El objetivo es describir aspectos epidemiológicos de la infección genital por el virus papiloma humano de alto riesgo (VPH-AR) en mujeres de 25 a 64 años que consultaron en servicios de Patología Cervical del MSPyBS, de mayo a diciembre de 2013. Se utilizó el Cobas 4800 HPV Test (Roche) que permite la detección individual de VPH-16 y VPH-18 y un pool de otros VPH-AR que incluye 12 genotipos de alto riesgo. Los otros VPH-AR fueron tipificados por hibridación reversa en línea (RLB). Entre las 495 mujeres incluidas, se detectaron 72 casos positivos (14,5%) de VPH-AR. Se identificaron 19 tipos virales; siendo el más frecuente VPH-16 (2,1%), seguido del VPH-31, 33, 58 y 66; el VPH-18 aparece en sexto lugar. Este trabajo aporta los primeros datos sobre la implementación de técnicas moleculares para detección y tipificación de VPH como parte del sistema de salud pública de Paraguay. El predominio de VPH-16, confirma su amplia circulación a nivel mundial y dado su mayor potencial oncogénico, representa una alerta a considerar, en especial en las mujeres mayores de 30 años portadoras de una infección persistente. Estos resultados apoyan la importancia de la implementación criteriosa y la utilización apropiada de las pruebas moleculares actualmente disponibles para la prevención y control del CCU(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Papillomaviridae/genetics , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/virology , Papillomavirus Infections/epidemiology , Papillomavirus Infections/virology , Paraguay/epidemiology , Cross-Sectional Studies , Human papillomavirus 16/genetics , Human papillomavirus 18/genetics , Genotyping Techniques
8.
Rev. medica electron ; 41(1): 203-210, ene.-feb. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-991338

ABSTRACT

RESUMEN El cáncer cérvico uterino, causa alrededor de 250 000 muertes anuales en el mundo y alrededor de 400 en Cuba, a pesar del esfuerzo que realiza el MINSAP, a través del Programa de Pesquisaje. Con el mismo se puede obtener el diagnóstico de lesiones precursoras del cáncer de cuello uterino, este diagnóstico citológico se realiza en Cuba a través del método de Richard y Barron que demuestra que existe un progreso citológico aparente hasta llegar al cáncer, que comienza con neoplasia intraepitelial (NICI a NICIII y carcinoma in situ), hasta finalmente el cáncer invasor. Por otro lado existe el método de Bethesda que responde casi todas las interrogantes que la citología plantea para su enfrentamiento, evidentemente los mayores aportes y revisiones se enfocan al manejo de las citologías atípicas de significado incierto, ya que no sólo presentan un mayor número de posibles evaluaciones, sino que representan el mayor porcentaje de citologías alteradas y la inclusión del VPH en las lesiones de bajo grado. En Cuba todavía se clasifica por el método de Richard y no se utiliza el Bethesda. Por la alta incidencia de esta entidad el propósito de este trabajo es emitir consideraciones sobre la implementación del sistema de Bethesda en el diagnóstico citológico de lesiones precancerosas del cérvix.


ABSTRACT The cervical-uterine cancer causes almost 250 000 death a year around the world and around 400 in Cuba in spite of the efforts made by the Public Health Ministry through the Screening Program. With it, the diagnosis of lesions that are predecessors of the cervical cancer could be reached. This cytological diagnosis is carried out through the Richard and Barron method, showing that there is an apparent cytological progress leading to the cancer that begins with intraepithelial neoplasia (NICI and NICIII and carcinoma in-situ) and ends in the invasive cancer. From the other hand there is the Bethesda methods answering to all the questions cytology ask for confronting it. Obviously the biggest contributions and reviews are focused in the management of the atypical cytologies with uncertain significance since they not only have a higher number of possible evaluations, but also represent the highest percent of the altered cytologies and the inclusion of the HPV in low grade lesions. The classification in Cuba is still made by the Richard method and the Bethesda one is not used. Due to the high incidence of this entity, the aim of this article is exposing considerations on the implementation of the Bethesda system in the cytological diagnosis of cervix pre-cancerous lesions.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/virology , Cytological Techniques/standards , Papillomavirus Infections/diagnosis , Papillomavirus Infections/pathology , Papillomavirus Infections/virology , Biopsy, Fine-Needle/methods , National Health Programs , Preventive Health Services , Disease Prevention
9.
Biol. Res ; 52: 33, 2019. tab, graf
Article in English | LILACS | ID: biblio-1019498

ABSTRACT

BACKGROUND: Studies have shown that cancer susceptibility candidate 11 (CASC11), a newly discovered long non-coding RNA (lncRNA), was aberrantly overexpressed in hepatic carcinoma, gastric cancer and colorectal cancer. However, its effects on cervical cancer has been kept unknown up to now. The present study was aimed to investigate the relationship between lncRNA CASC11 and cervical cancer and further explore the mechanism of CASC11 effect on cervical cancer progression. MATERIALS: Quantitative real-time polymerase chain reaction (RT-qPCR) was used to detect the expressions of CASC11 in cancerous and adjacent normal tissues of patients with cervical cancer as well as in cell lines. The proliferation, migration, invasion and apoptosis were assayed after transfecting the cell with si-CASC11 or pcDNA3.1-CASC11. TOP/FOP-Flash luciferase reporter assay and western blot were used to analysis the activation of Wnt/ß-catenin signaling pathway. Si-CASC11-transfected HeLa cells were subcutaneously inoculated into male athymic (nude) mice to investigate the effect of CASC11 on the tumor formation. RESULTS: We discovered that CASC11, the expression of which was positively associated with the tumor size and the FIGO staging and negatively related to the patients' survival rate, was up-regulated in the cervical cancer tissues and cell lines. Silencing CASC11 inhibited the proliferation, migration as well as invasion and promoted the cell apoptosis. Conversely, overexpression of CASC11 facilitated the cancer cell's proliferation, migration and invasion ability and suppressed the apoptosis. Further study showed that CASC11 promoted the migration and invasion of cervical cancer cells by activating Wnt/ß-catenin signaling pathway and silencing CASC11 inhibited the tumor growth in vivo. CONCLUSION: Our study demonstrated that CASC11 promoted the cervical cancer progression by activating Wnt/ß-catenin signaling pathway for the first time, which provides a new target or a potential diagnostic biomarker of the treatment for cervical cancer.


Subject(s)
Humans , Animals , Female , Mice , Uterine Cervical Neoplasms/genetics , Uterine Cervical Neoplasms/pathology , Genetic Predisposition to Disease , MicroRNAs/genetics , beta Catenin/genetics , Wnt Signaling Pathway/genetics , Uterine Cervical Neoplasms/virology , Apoptosis/genetics , Disease Progression , Papillomavirus Infections/complications , Cell Proliferation/genetics , Genome-Wide Association Study , Flow Cytometry
11.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 16(3): 6-12, dic. 2018. tab, ilus
Article in Spanish | LILACS, BDNPAR | ID: biblio-998219

ABSTRACT

El cáncer de cuello uterino es el segundo cáncer femenino más común a nivel mundial. El agente causal es el virus de papiloma humano (VPH). Se han identificado 13 tipos de virus de papiloma humano de alto riesgo oncogénico (VPH-AR), entre los cuales el VPH 16 y VPH 18 son los más frecuentemente detectados en cáncer de cuello uterino, siendo en Paraguay detectados en el 70% de casos de cáncer invasor. Por ello, el objetivo fue estandarizar y determinar el límite de detección de una técnica de PCR convencional para la detección de VPH 16 y 18. Para la detección de ADN de VPH 16 y 18, se observaron mejores resultados con 2mM de MgCl2 y 60°C para la temperatura de alineamiento. El límite de detección para las PCR fue de 14,6x10-11ng/µL para VPH 16 y 21,7x10-12ng/µL para VPH 18. Este trabajo servirá de base a otros estudios de detección e identificación de estos tipos virales por PCR, con miras a identificar un grupo de mujeres positivas para VPH-AR que poseen mayor riesgo de desarrollo de lesión y cáncer de cuello uterino y precisan de un seguimiento más cercano(AU


Cervical cancer is the second most common female cancer worldwide. It is caused by the human papilloma virus (HPV). Thirteen genotypes of high oncogenic risk human papilloma viruses (HPV-HR) have been identified, among which types 16 and 18 are the most frequently detected in cervical cancer. In Paraguay, they are detected in 70% of the invasive cancer cases. Therefore, the objective was to standardize and determine the detection limit of a conventional PCR technique for the detection of HPV 16 and 18. Better results were observed with 2mM MgCl2 and 60°C for the alignment temperature in detection of HPV 16 and 18 DNA. The limit of detection was 14.6x10-11ng/µL for HPV 16 and 21.7x10-12ng/µL for HPV 18. This work will help other studies for the detection and identification of these viral types by PCR in order to identify a group of HPV-HR positive women who have higher risk for the development of lesions and cervical cancer and need a closer follow-up(AU)


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/virology , Polymerase Chain Reaction/methods , Papillomavirus Infections/virology , Human papillomavirus 16/genetics , Human papillomavirus 18/genetics , Base Sequence , Genome, Viral , DNA Primers , Electrophoresis, Polyacrylamide Gel , Limit of Detection
13.
Rev. bras. ginecol. obstet ; 40(6): 360-368, June 2018. tab, graf
Article in English | LILACS | ID: biblio-958999

ABSTRACT

Abstract Evidence-based clinical guidelines ensure best practice protocols are available in health care. There is a widespread use of human papillomavirus deoxyribonucleic acid (HPVDNA) tests in Brazil, regardless of the lack of official guidelines. On behalf of the Brazilian Association for the Lower Genital Tract Pathology and Colposcopy (ABPTGIC, in the Portuguese acronym), a team of reviewers searched for published evidence and developed a set of recommendations for the use of HPV-DNA tests in cervical cancer screening in Brazil. The product of this process was debated and consensus was sought by the participants. One concern of the authors was the inclusion of these tests in the assessment of women with cytologic atypia and women treated for cervical intraepithelial neoplasia (CIN). Testing for HPV is recommended in an organized screening scenario to identify women with precursor lesions or asymptomatic cervical cancer older than 30 years of age, and it can be performed every 5 years. It also has value after the cytology showing atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSILs) as a triage test for colposcopy, in the investigation of other cytological alterations when no abnormal findings are observed at colposcopy, seeking to exclude disease, or, further, after treatment of high-grade cervical intraepithelial neoplasia, to rule out residual disease.


Resumo O uso de diretrizes clínicas baseadas em evidências visa assegurar as melhores práticas na área de cuidado à saúde. O uso de testes de ácido desoxirribonucleico de papilomavírus humano (DNA-HPV) vem crescendo e se disseminando sem que existam recomendações de uso no cenário brasileiro.Emnomeda Associação Brasileira de Patologia doTrato Genital Inferior e Colposcopia (ABPTGIC), grupos de revisores pesquisaram evidências e formularamrecomendações para o uso dos testes de DNA-HPV no rastreamento do câncer do colo do útero, no seguimento de mulheres com atipias citológicas, e após tratamento de neoplasia intraepitelial cervical (NIC). O produto desse processo foi debatido e foi buscado consenso entre participantes. Os testes de DNA-HPV são recomendados num cenário de rastreamento organizado para identificação de mulheres portadoras de lesões precursoras ou câncer assintomático com mais de 30 anos e podem ser realizados a cada 5 anos. Também têm valor após a citologia mostrando células escamosas atípicas de significado indeterminado (ASC-US) ou lesão intraepitelial escamosa de baixo grau (LSIL) como teste de triagempara colposcopia, na investigação de outras alterações citológicas quando não são observados achados anormais à colposcopia, buscando excluir doença, ou, ainda, no seguimento após tratamento das neoplasias intraepiteliais de alto grau, para exclusão de doença residual.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/virology , Papillomavirus Infections/diagnosis , Human Papillomavirus DNA Tests/standards , Early Detection of Cancer/methods
14.
Rev. chil. obstet. ginecol. (En línea) ; 83(2): 130-138, abr. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-959497

ABSTRACT

RESUMEN Fundamento: La persistencia del virus papiloma posterior a la conización del cuello uterino, se ha considerado un factor de riesgo para la persistencia de lesiones intra epiteliales (LIE) causadas por virus papiloma. Para determinar la asociación entre persistencia de lesión cervical y la presencia del virus papiloma posterior a la conización del cuello uterino, se realizó un estudio observacional prospectivo en un grupo de 123 pacientes portadoras de lesiones intraepiteliales de alto grado (LIEAG) tratadas con conización. Material y métodos: Se siguieron a 123 pacientes portadoras de LIEAG, ingresadas a la Unidad de Patología Cervical entre Abril de 2013 y Abril de 2014, las que fueron seguidas por 2 años hasta Abril de 2016. Se realizó genotipificación antes, y entre 4 a 6 meses posterior a la conización. Los datos se tabularon considerando la edad, paridad, tipo de virus, persistencia de LIE, reconización o requerimiento de histerectomía posterior. Resultados: La mediana de la edad fue de 37 años, el 91% fueron multíparas, y solo el 9% fueron nulíparas. El 56% ingresó por NIE III y el 44% por NIE II. Los virus más frecuentes fueron el 16, 31,58, 52 y 56. La persistencia de virus papiloma se constató en el 37% de las pacientes conizadas. La persistencia de LIE se observó en el 27% de las pacientes que fueron positivas para virus papiloma posterior a la conización, en comparación a sólo el 5% en las que fueron negativas. Del total de pacientes positivas para virus papiloma posterior a la conización, 12 de ellas presentaron persistencia de lesión confirmadas histológicamente por biopsia cervical, 8 pacientes requirieron recono por LIE de alto grado, 2 pacientes fueron a histerectomía y en 2 casos se realizó seguimiento estricto por NIE I. Cuando la tipificación post cono fue negativa solamente 3 pacientes requirieron conización y en sólo una se realizó seguimiento estricto por NIE I. Conclusión: La persistencia del virus papiloma posterior a la conización se asocia a mayor persistencia de LIEAG, mayor frecuencia de reconización o histerectomía posterior.


ABSTRACT Backgroud: The persistence of papilloma virus after conization of the cervix has been considered a risk factor for the persistence of cervical intra epithelial lesion (CIN) caused by papilloma virus. Aim: In order to determine the association between cervical lesion persistence and the presence of papilloma virus after conization, a prospective observational study was performed in a group of 123 patients with intraepithelial lesions treated with conization. Material and methods: We followed 123 patients with high grade CIN who were admitted to the Cervical Pathology Unit, between April 2013 and April 2014; they were followed for 2 years until April 2016. Viral genotyping was done before, and among the 4 to 6 months after the LEEP. Data were tabulated considering age, parity, type of virus, persistence of CIN, reconization or requirement of posterior hysterectomy. Results: The median age was 37 years, 91% were multiparous, and only 9% were nulliparous. 56% had NIE III and 44% NIE II. The most frequent viruses were 16, 31, 58, 52 and 56. The persistence of papillomavirus was present in 37% of patients. The persistence of CIN was observed in 27% of patients who were positive for papilloma virus after conization, compared to only 5% in those who were negative. Of the total number of patients positive for papilloma virus, in 12 of them had intra epitelial lesions were confirmed by cervical biopsy, 8 patients required recone for high grade CIN, 2 patients underwent hysterectomy, and 2 patients underwent follows up strictly by CIN I. When post cone typing was negative only 3 patients required conization and only one was followed strictly by CIN I.


Subject(s)
Humans , Female , Adult , Middle Aged , Young Adult , Uterine Cervical Neoplasms/surgery , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/virology , Conization , Papillomavirus Infections/pathology , Papillomaviridae/physiology , Biopsy , Uterine Cervical Neoplasms/complications , Prospective Studies , Follow-Up Studies , Cervical Intraepithelial Neoplasia/surgery , Cervical Intraepithelial Neoplasia/pathology , Colposcopy , Cytodiagnosis , Papillomavirus Infections/genetics , Observational Study
15.
Braz. j. infect. dis ; 22(1): 16-23, Jan.-feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-951626

ABSTRACT

ABSTRACT Introduction: Cervical cancer remains an important burden for HIV-infected women in the era of combination antiretroviral therapy. Recommendations for cervical screening in these women diverge and may include high-risk HPV (HRHPV) testing. We aimed to evaluate the clinical usefulness of a single HRHPV testing for cervical screening of HIV-infected women. Methods: 723 HIV-infected women from a Brazilian prospective cohort were included between 1996 and 2012. Inclusion criteria were: normal cervical cytology at baseline and having a HRHPV-test at baseline. We calculated incidence rates of any squamous intraepithelial lesion (SIL) and high grade SIL+ (HSIL+) and negative predictive values (NPV) within 12 and 36 months. Hazard Ratios were obtained using Cox proportional hazards regression models. Results: Incidence rate for both outcomes was low (9.9 cases per 100 PY [95% CI 8.8-11.0] for any SIL and 1.3 cases per 100 PY [95% IC 0.9-1.8] for HSIL+). Women with a HRHPV positive status at baseline had 1.7-fold (95% CI 1.3-2.2) and 3.2-fold (95% CI 1.5-7.1) increased risk of presenting any SIL and HSIL+, respectively, during follow-up. Negative-HRHPV test presented high NPV for both periods and outcomes (any SIL: 92.4% [95% CI 89.7-94.6] for 12 months and 80.9% [95% CI 77.2-84.3] for 36 months; and HSIL+: 99.8% [95% CI 98.9-100.0] for 12 months and 99.0 [95% CI 97.6-99.7] for 36 months). Conclusions: Incidence of any and high grade cytological abnormality was significantly higher among HIV-infected women with positive-HRHPV test. A single negative-HRHPV test helped reassure follow-up free of cytological abnormalities through three years of follow-up in HIV-infected women with negative cytology.


Subject(s)
Humans , Female , Adult , HIV Infections/complications , Mass Screening/methods , Risk Assessment/methods , Papillomavirus Infections/complications , Squamous Intraepithelial Lesions of the Cervix/diagnosis , Squamous Intraepithelial Lesions of the Cervix/virology , Reference Values , Time Factors , Proportional Hazards Models , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/virology , Multivariate Analysis , Predictive Value of Tests , Prospective Studies , Reproducibility of Results , Risk Factors , CD4 Lymphocyte Count , Viral Load , Early Diagnosis , Squamous Intraepithelial Lesions of the Cervix/pathology
16.
Einstein (Säo Paulo) ; 16(3): eAO4190, 2018. tab
Article in English | LILACS | ID: biblio-953185

ABSTRACT

ABSTRACT Objective To investigate the relation between oxidative stress markers, human papillomavirus infection and cervical cancer precursor lesions. Methods The study comprised women aged 14 to 60 years living in communities located by Amazon rivers in the state of Pará (Itaituba, Limoeiro do Ajuru and Bragança, 126, 68 and 43 women respectively). Papanicolau smears and polymerase chain reaction tests for human papillomavirus DNA detection were performed. Blood samples were collected to test malondialdehyde, total and oxidized glutathione levels. Results Malondialdehyde, total and oxidized glutathione concentrations did not differ significantly (p>0.05) between women with and without low-grade squamous intraepithelial lesions across communities. Malondialdehyde levels (8.02nmols/mL) were almost five times higher in human papillomavirus-positive compared to human papillomavirus-negative women (1.70nmols/mL) living in Itaituba (statistically significant difference; p<0.05). Malondialdehyde levels did not differ significantly (p>0.05) between human papillomavirus-positive and human papillomavirus-negative women living in remaining communities. Significant (p<0.05) differences in total glutathione levels between human papillomavirus-positive and human papillomavirus-negative women (8.20μg/mL and 1.47μg/mL, respectively) were limited to those living in Bragança. Conclusion Malondialdehyde and total glutathione levels were significantly associated with human papillomavirus infection. However, lack of similar associations with squamous lesions suggest oxidative stress alone does not explain correlations with cervical carcinogenesis. Other factors may therefore be involved.


RESUMO Objetivo Avaliar a relação de marcadores de estresse oxidativo com a infecção pelo papilomavírus humano e as lesões precursoras do câncer cervical. Métodos Foram incluídas mulheres ribeirinhas da Amazônia (a saber: 126 do município de Itaituba, 68 de Limoeiro do Ajuru e 43 de Bragança), todas do Estado do Pará, de 14 a 60 anos. Foram realizados testes Papanicolau e de reação em cadeia de polimerase para a detecção de DNA do papilomavírus humano. Coleta de amostras de sangue foi realizada para a avaliação do malondialdeído e a determinação da glutationa total e oxidada. Resultados As concentrações oxidativas do malondialdeído e os teores de glutationa total e oxidada não apresentaram diferença significativa (p>0,05) nas mulheres com e sem lesão intraepitelial escamosa de baixo grau, em todas as comunidades pesquisadas. Mulheres com papilomavírus humano em Itaituba apresentaram níveis de malondialdeído (8,02nmols/mL) quase cinco vezes maior quando relacionadas àquelas sem o HPV (1,70nmols/mL), com diferença estatística significativa (p<0,05). As outras comunidades não mostraram diferença estatística significativa entre as concentrações de malondialdeído nas mulheres com e sem papilomavírus humano (p>0,05). Os teores de glutationa total mostraram diferença significativa (p<0,05) somente em Bragança naquelas com (8,20µg/mL) e sem a infecção pelo papilomavírus humano (1,47µg/mL). Conclusão Houve associação significativa da resposta oxidativa do malondialdeído e da glutationa total com a infecção pelo papilomavírus humano, porém não houve diferença quando associada à lesão escamosa, sugerindo que o estresse oxidativo isoladamente não explica a relação com a carcinogênese do colo uterino, que deve ser influenciada ainda por outros fatores.


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Uterine Cervical Neoplasms/blood , Oxidative Stress/physiology , Glutathione Disulfide/blood , Papillomavirus Infections/blood , Squamous Intraepithelial Lesions of the Cervix/blood , Glutathione Peroxidase/blood , Malondialdehyde/blood , Papillomaviridae/isolation & purification , Reference Values , Severity of Illness Index , Brazil , DNA, Viral , Biomarkers, Tumor/blood , Uterine Cervical Neoplasms/virology , Polymerase Chain Reaction , Cross-Sectional Studies , Statistics, Nonparametric , Papillomavirus Infections/complications , Rivers , Papanicolaou Test , Squamous Intraepithelial Lesions of the Cervix/virology , Middle Aged
18.
Clinics ; 73(supl.1): e548s, 2018. graf
Article in English | LILACS | ID: biblio-974955

ABSTRACT

OBJECTIVES: Oxidative stress results from an imbalance between the generation and elimination of oxidant species. This condition may result in DNA, RNA and protein damage, leading to the accumulation of genetic alterations that can favor malignant transformation. Persistent infection with high-risk human papillomavirus types is associated with inflammatory responses and reactive oxygen species production. In this context, oxidative stress, chronic inflammation and high-risk human papillomavirus can act in a synergistic manner. To counteract the harmful effects of oxidant species, protective molecules, known as antioxidant defenses, are produced by cells to maintain redox homeostasis. In recent years, the use of natural antioxidants as therapeutic strategies for cancer treatment has attracted the attention of the scientific community. This review discusses specific molecules and mechanisms that can act against or together with oxidative stress, presenting alternatives for cervical cancer prevention and treatment.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/metabolism , Uterine Cervical Neoplasms/drug therapy , Oxidative Stress/drug effects , Antioxidants/therapeutic use , Uterine Cervical Neoplasms/virology , Reactive Oxygen Species/metabolism , Apoptosis/drug effects , Papillomavirus Infections/metabolism , Papillomavirus Infections/drug therapy , Enzyme Inhibitors/therapeutic use
19.
Clinics ; 73(supl.1): e549s, 2018. tab, graf
Article in English | LILACS | ID: biblio-974946

ABSTRACT

Most human papillomavirus infections are readily cleared by the host immune response. However, in some individuals, human papillomavirus can establish a persistent infection. The persistence of high-risk human papillomavirus infection is the major risk factor for cervical cancer development. These viruses have developed mechanisms to evade the host immune system, which is an important step in persistence and, ultimately, in tumor development. Several cell types, receptors, transcription factors and inflammatory mediators involved in the antiviral immune response are viral targets and contribute to tumorigenesis. These targets include antigen-presenting cells, macrophages, natural killer cells, Toll-like receptors, nuclear factor kappa B and several cytokines and chemokines, such as interleukins, interferon and tumor necrosis factor. In the present review, we address both the main innate immune response mechanisms involved in HPV infection clearance and the viral strategies that promote viral persistence and may contribute to cancer development. Finally, we discuss the possibility of exploiting this knowledge to develop effective therapeutic strategies.


Subject(s)
Humans , Female , Papillomaviridae/immunology , Uterine Cervical Neoplasms/virology , Papillomavirus Infections/virology , Immunity, Innate/immunology , Cell Transformation, Neoplastic , Disease Progression , Immune Evasion
20.
Clinics ; 73: e679, 2018. tab, graf
Article in English | LILACS | ID: biblio-974917

ABSTRACT

OBJECTIVE: This study investigated serum interleukin-10 (IL-10) levels, changes in peripheral blood CD4+CD25+ regulatory T cell (PBCDT) ratios, and the prognosis of cervical cancer (CC) patients. METHODS: Seventy patients with CC composed the observation group, and 70 healthy subjects composed the control group. The PBCDT ratios in the CC patients and healthy subjects were calculated. Serum IL-10 levels were detected with a double antibody sandwich enzyme-linked immunosorbent assay (ELISA). RESULTS: The PBCDT ratio was higher in the patients with active CC [12.16±2.41%] than in the control subjects [6.34±1.05%]. Serum IL-10 levels were higher in the patients with CC [384±106 pg/ml] than in the control subjects [104±50 pg/ml]; the differences in both PBCDT ratio and IL-10 level were statistically significant (p<0.01). Serum IL-10 levels were positively correlated with PBCDT ratios (r=0.375, p<0.05). The 5-year patient survival rate was significantly higher in the low serum IL-10 group (64.2%) than in the high serum IL-10 group (42.8%, p=0.012). CONCLUSIONS: PBCDT ratios and serum IL-10 levels are related to CC activity. These factors are reciprocally related and influence one another, and both are involved in the development and progression of CC. Low IL-10 expression is beneficial regarding the survival of patients with CC.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Antigens, CD/blood , Uterine Cervical Neoplasms/immunology , Interleukin-10/blood , T-Lymphocytes, Regulatory/cytology , Prognosis , Socioeconomic Factors , Enzyme-Linked Immunosorbent Assay , Biomarkers, Tumor/blood , Case-Control Studies , Uterine Cervical Neoplasms/blood , Uterine Cervical Neoplasms/virology , Interleukin-10/immunology , Papillomavirus Infections/complications , Papillomavirus Infections/diagnosis , Kaplan-Meier Estimate , Flow Cytometry , Neoplasm Staging
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