Association between human papillomavirus and Epstein - Barr virus DNA and gene promoter methylation of RB1 and CDH1 in the cervical lesions: a transversal study.

BACKGROUND: Human papillomavirus (HPV) inactivates the retinoblastoma 1 (RB1) gene by promoter methylation and reduces cellular E-cadherin expression by overexpression of DNA methyltransferase 1 (DNMT1). The Epstein-Barr virus (EBV) is an oncogenic virus that may be related to cervical carcinogenesis. In gastric cancer, it has been demonstrated that E-cadherin gene (CDH1) hypermethylation is associated with DNMT1 overexpression by EBV infection. Our aim was to analyze the gene promoter methylation frequency of RB1 and CDH1 and verify the association between that methylation frequency and HPV and EBV infection in cervical lesions. METHODS: Sixty-five samples were obtained from cervical specimens: 15 normal cervices, 17 low-grade squamous intraepithelial lesions (LSIL), 15 high-grade squamous intraepithelial lesions (HSIL), and 18 cervical cancers. HPV and EBV DNA testing was performed by PCR, and the methylation status was verified by MSP. RESULTS: HPV frequency was associated with cervical cancer cases (p = 0.005) but not EBV frequency (p = 0.732). Viral co-infection showed a statistically significant correlation with cancer (p = 0.027). No viral infection was detected in 33.3% (5/15) of controls. RB1 methylated status was associated with cancer (p = 0.009) and HPV infection (p = 0.042). CDH1 methylation was not associated with cancer (p = 0.181). Controls and LSIL samples did not show simultaneous methylation, while both genes were methylated in 27.8% (5/18) of cancer samples. In the presence of EBV, CDH1 methylation was present in 27.8% (5/18) of cancer samples. Only cancer cases presented RB1 promoter methylation in the presence of HPV and EBV (33.3%). CONCLUSIONS: The methylation status of both genes increased with disease progression. With EBV, RB1 methylation was a tumor-associated event because only the cancer group presented methylated RB1 with HPV infection. HPV infection was shown to be significantly correlated with cancer conditions. The global methylation frequency was higher when HPV was present, showing its epigenetic role in cervical carcinogenesis. Nevertheless, EBV seems to be a cofactor and needs to be further investigated. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1159157579149317 .

Metalloproteinases 2 and 9 and their tissue inhibitors 1 and 2 are increased in vulvar lichen sclerosus.

OBJECTIVES: To evaluate the expression of different matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in vulvar lichen sclerosus (LS), a chronic dermatosis in women, histologically characterized by a zone of collagen remodeling in the superior dermis. STUDY DESIGN: Analysis of the expression of different MMPs (MMP-1, -2, -9 and -13) and TIMPs (TIMP-1 and -2) by reverse transcriptase-polymerase chain reaction (RT-PCR) in vulvar biopsies from patients with LS (n=11), classified according to Hewitt histological criteria and compared with clinically normal vulvar tissue (n=5), and the immunohistochemistry of MMP-2 and -9 and TIMP-1 and -2 distribution in the remodeling zone of LS (n=31) and in clinically normal vulvar tissue (n=28). RESULTS: Although no statistically significant difference between LS and normal skin groups at the mRNA level of MMP and TIMP transcripts was shown, an increase in the immunodistribution of MMP-2 and -9 and TIMP-1 and -2 in LS compared to normal vulvar skin was observed. CONCLUSIONS: These results suggest that these molecules could be related to the process of cutaneous collagen remodeling in LS pathology.

Chronic hidradenitis suppurativa and perianal mucinous adenocarcinoma. A case report.

BACKGROUND: Hidradenitis is a chronic and suppurative inflammation of the apocrine sudoriparous glands. When located in the genital and perianal regions, it may be associated with cancer. This is the first case report of hidradenitis suppurativa in the vulvar region associated with perianal mucinous adenocarcinoma. CASE: The patient was a 48-year-old woman who presented with extensive hidradenitis suppurativa in the vulvar and perianal regions. She had a 10-year history of hidradenitis suppurativa, previously managed at other institutions, with no satisfactory response. She underwent a simple vulvectomy and resection of the perianal region. A diagnosis of perianal mucinous adenocarcinoma was made. An abdominoperineal resection was performed, followed by a combination of adjuvant radiation. The patient was well for 1 year after treatment. The disease later recurred in the perianal region and resulted in the patient's death. CONCLUSION: Treatment of hidradenitis suppurativa of the genital and perianal regions may be clinical or surgical, depending on the extensiveness and seriousness of the disease. Surgery remains the treatment of choice for chronic and severe cases. Association with malignancy, although very rare, is the most serious complication.

Gestação após injeção intracitoplasmática de espermatozóides - ICSI - em casal sorodiscordante para HIV-I: tempo de refletir sobre AIDS e reprodução / Pregnancy following intracytoplasmic sperm injection - ICSI from a HIV-I serodiscordant couple time to think about AIDS and reproduction

Casal sorodiscordante para HIV-I foi submetido a ciclo de fertilização in vitro pela técnica de injeção intracitoplasmática de espermatozóides - ICSI, após preparo de sêmen em gradientes de densidade seguido de swim-up, com obtenção de gestação única em curso

Vulvar intraepithelial neoplasia p53 expression, p53 gene mutation and HPV in recurrent/progressive cases.

OBJECTIVE: To evaluate p53 protein overexpression and p53 gene mutation in primary and recurrent undifferentiated vulvar intraepithelial neoplasia (VIN), establishing the recurrence and progression rates, median time interval, and sites of the initial lesion and first recurrence, addressing the relationship with HPV infection. STUDY DESIGN: Twenty women with undifferentiated VIN treated with wide surgical excision were followed every 6 months for 7 years and divided into groups with and without recurrence/progression. p53 Protein was detected in paraffin sections using the monoclonal p53 antibody. DNA was extracted from paraffin sections. Polymerase chain reaction/single strand conformation polymorphism (PCR-SSCP) analysis was utilized to screen for p53 gene mutations in exons 5-8. HPV was determined by digesting PCR products with restriction endonucleases. RESULTS: Recurrences were observed in 8 (40%) patients and progression to cancer in 1 (5%). Two cases recurred twice. The median interval for recurrence/progression was 24.5 months. Recurrent/progressive lesions were located in the same area of the initial lesions in 10 cases (91%). p53 Overexpression was observed in 50% (10/20) of primary lesions, of which 45% corresponded to the 9 recurrent/progressive cases. p53 Overexpression was detected in 81.8% (9/11) of recurrent/progressive cases. In the last 2 cases PCR-SSCP showed p53 gene mutation. The rate of HPV infection was higher in the group without recurrence. CONCLUSION: p53 Gene mutation plays an important role in undifferentiated VIN pathogenesis independent of high-risk HPV infection and may predict recurrence or progression to vulvar cancer. Undifferentiated VIN recurrent/progressive VIN lesions have a tendency to occur in the same area of the initial lesions, suggesting a molecular disturbance.

Estudo comparativo de diferentes formas de tratamento de condilomas acuminados / Comparative study of different ways of treatment on genital wart

Observação de diferentes formas terapêuticas de pacientes apresentando condiloma acuminado, observação da ocorrência de associação com sífilis

História natural da neoplasia intra-epitelial vulvar / The natural history of vulvar intraepithelial neoplasia

A infecção induzida pelo HPV no trato anogenital contitui-se atualmente em verdadeira epidemia

Anormalidades citológicas e a acurácia da citopatologia como método de rastreio nas mulheres HIV soro-positivas/AIDS / Citological abnormalities and the accuracy of cytology as the screening method in HIV seropositive/AIDS women

O número de mulheres infectadas pelo HIV tem aumentado e a sua consequente imunossupressäo, alterado a história natural do HPV. O HPV, em especial o de alto risco oncogênico, é considerado agente principal das lesöes precursoras do cäncer cérvico-uterino. Por isso,o grupo de mulheres soropositivas apresenta maior incidência de CIN

Perfil do atendimento ao adolescente no Setor de Doenças Sexualmente Transmissíveis da Universidade Federal Fluminense / Adolescents at the STD Sector of the Universidade Federal Fluminense

Caracterizar o atendimento do adolescente de ambos os sexos no Setor de Doenças Sexualmente Transmissíveis da Universidade Federal Fluminense no ano de 1995. Realizou-se um levantamento a partir da revisäo dos prontuários de todos os adolescentes atendidos no Setor. Foram coletados os dados referentes a sexo, idade, idade que iniciou as relaçöes sexuais, cor, estado civil, município de moradia, método contraceptivo, forma de encaminhamento ao setor, profissäo, fidelidade ao parceiro, número de retornos ao serviço, número de gestaçöes, queixa principal, história prévia de DST, e patologia diagnosticada

Condilomatose na gestaçäo / Condylomatosis in pregnant

A partir da tetecçäo clínica dos casos de condilomatose em gestantes, no Setor de Doenças Sexualmente Transmissíveis, da Universidade Federal Fluminense percebeu-se a relevåncia do tema. Versa sobre o perfil epidemiológico da condilomatose na gestaçäo, uma vez que a infecçäo pelo Papilomavírus Humano apresentou-se com a DST mais frequente nos estudos elaborados, em gestantes no Setor de DST-UFF. A pesquisa foi feita através da análise de prontuários do primeiro atendimento clínico, no período de janeiro de 1999 a julho de 2000. Foram estudados 1344 prontuários, sendo selecionados 569 pertencentes ao sexo feminino. Como objeto de estudo, a gravidez incidiu sobre 12,5 por cento destas mulheres

Tratamento da endometriose pélvica com acetato de medroxiprogesterona / Treatment of pelvic endometriosis with medroxiprogesterone acetate

Estudo de dez casos com endometriose pélvica em pacientes do Instituto de Ginecologia da Universidade Federal do Rio de Janeiro, tratadas por período de nove meses, exclusivamente com acetato de medroxiprogesterona. A suspeiçao diagnóstica baseou-se na história clínica e exame ginecológico e a confirmaçao foi feita por laparoscopia com biópsia e exame histopatológico. O seguimento clínico fez-se mensalmente. Laparoscopia de controle (second look) foi realizada um ano após o início da terapêutica.A endometriose pélvica foi mais freqüente nas mulheres na faixa dos trinta anos (50 por cento). A principal queixa foi a esterilidade primária (60 por cento). Oitenta por cento das pacientes eram nuligestas. Tumor e dor ao exame ginecológico estiveram presentes em 40 por cento. A maioria das pacientes encontrava-se nos estágios I (30 por cento) e II (40 por cento). Os melhores resultados foram obtidos nos estágios iniciais da doença; respostas subjetivas e objetivas, observadas no final do 3( trimestre, nao foram melhores do que as observadas no 2( trimestre; a terapia com acetato de medroxiprogesterona representa uma opçao eficaz e menos dispendiosa no tratamento da endometriose pélvica.