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Contexte et objectifs. L'adénocarcinome du col utérin a fait l'objet de peu de publications notamment en Afrique. L'objectif de la présente étude était de décrire les aspects cliniques, pathologiques et évolutifs de ce cancer au Gabon puis d'évaluer la reproductibilité du pattern d'invasion (PI) afin d'améliorer le choix thérapeutique. Méthodes. Il s'agissait d'une série des cas d'adénocarcinomes du col utérin confirmés histologiquement en 8 ans. Les données clinico-pathologiques et le suivi ont été enregistrés à partir des dossiers médicaux. 3 pathologistes ont évalué le PI de chaque cas puis, la reproductibilité a été réalisée. Résultats.Sur les 378 cas recensés, 16 ont été retenus. Leur âge moyen était de 57 ans. Les femmes étaient de grandes multipares (68,7 %) et ayant consulté pour des métrorragies (87,5 %). Elles étaient récués à un stade clinique avancé (62,5 %) et l'évolution était défavorable dans 81,25 % des cas. Le type endocervical et le grade intermédiaire étaient les plus fréquents. Le niveau de concordance du PI était faible (28,6 %). Conclusion. L'adénocarcinome du col utérin au Gabon survient chez la femme d'âge jeune, grande multipare, est de diagnostic tardif et d'évolution péjorative d'où l'intérêt d'assurer un dépistage précoce et une prévention. Par ailleurs, la reproductibilité du PI devrait être réévaluée par des études supplémentaires.
Subject(s)
Humans , Adenocarcinoma , Early Detection of Cancer , Cervix Uteri , Clinical ConferenceABSTRACT
ETHNOPHARMACOLOGICAL RELEVANCE: Skin cancer is the most common form of cancer responsible for considerable morbidity and mortality. Tieghemella africana and Ficus vogeliana are used in traditional medicine to treat cancers. AIM OF THE STUDY: Therefore, the aim of this study was to investigate the antioxidant, antiangiogenic and anti-tumor activities of these plant extracts. MATERIALS AND METHODS: To achieve it, phytochemical screening, antioxidant activity and antiangiogenic activity were assessed. Thereafter, the anti-tumor activity was determined using skin tumorigenesis induced by 7,12-dimethylbenz[a]anthracene. RESULTS: The phytochemical result analysis showed that both plant extracts were rich in polyphenols, alkaloids and terpene compounds and possessed good antioxidant activity based on DPPH radical scavenging (IC50 = 9.70 µg/mL and 4.60 µg/mL and AAI values of 5.20 and 10.88) and strong total antioxidant capacity (115.44 VtCE (mg)/g of dry plant extract and 87.37 VtCE (mg)/g of dry plant extract, respectively). Additionally, both plant extracts possessed antiangiogenic activities (IC50 = 53.43 µg/mL and 92.68 µg/mL, respectively), which correlated with significant antitumor activities when using 35 mg/kg (65.02% and 77.54%) and 70 mg/kg of extracts (81.07% and 88.18%). CONCLUSIONS: In summary, this study illustrates the promising usage of Tieghemella africana and Ficus vogeliana plant extracts in treating skin cancer. However, further characterization of the extracts must be performed to isolate the most active anticancer compound.
Subject(s)
9,10-Dimethyl-1,2-benzanthracene/toxicity , Ficus , Plant Extracts/therapeutic use , Sapotaceae , Skin Neoplasms/chemically induced , Skin Neoplasms/drug therapy , Animals , Carcinogens/toxicity , Chick Embryo , Male , Plant Extracts/isolation & purification , Rats , Rats, Wistar , Skin Neoplasms/pathology , Treatment Outcome , WaterABSTRACT
BACKGROUND: Cervical cancer is a real public health problem in African countries. The relation between HPV and cervical cancer is well established. However, it is known that the distribution of HPV genotypes differ geographically and this may influence the effectiveness of the three available vaccines, which among other HPV genotypes targets the genotypes 16 and 18 that cause about 70 % of cervical cancers cases. The objective of this study was to identify for the first time the HPV genotypes distribution in cervical cancer specimens obtained from Gabonese women. METHODS: A total of 105 cervical samples including 93 formalin-fixed paraffin embedded tissues collected between 2007 and 2013 and 12 fresh biopsies collected in August 2013 were investigated. The presence of HPV DNA was analyzed by nested PCR with primers MY09/11 and GP5+/6+ followed by sequencing for HPV genotyping. RESULTS: Amplification of the housekeeping gene (ß-globin) with PCO4/GH20 primers was successful for 91.4 % (96/105) of the cervical cancer samples and HPV DNA was detected in all the 96 samples. Five different HPV genotypes were identified. HPV 16 [58.3 %; 95 % IC: 48.44-68.16] was the most common genotype followed by HPV 33 [25.0 %; 95 % IC: 16.34-33.66], HPV 18 [8.4 %; 95 % IC: 2.86-13.94], HPV 70 [7.3 %; 95 % IC: 2.1-12.5] and HPV 31 [1.1 %; 95 % IC: -0.986-3.186]. HPV 16 was also the most prevalent in all histological malignant lesions. It was found in 56.6 % of squamous cervical carcinoma and 69.2 % of adenocarcinoma. Concerning the HPV positive adenocarcinoma cases, HPV 18 was identified in 7.7 % (1/13). CONCLUSION: These findings show the predominance of HPV 16 in cervical cancer cases among Gabonese women. However, HPV33 is more prevalent than HPV18. Our study suggests that HPV vaccines may be effective at reducing the burden of cervical cancer in Gabon.
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BACKGROUND: Cervical cancer is one of the most common tumors affecting women with a disproportionate mortality occurring in developing countries. Despite the high prevalence of cervical cancer and cervical neoplasia in Gabon, few studies have been performed to evaluate the prevalence and determinants of HPV infection in this country. The aim of this study was to determine the HPV prevalence and distribution in a population of Gabonese women with normal cytology and cervical abnormalities. METHODS: A total of 200 cervical samples collected in the "Departement d'Anatomie et de Cytologie Pathologiques" of the "Faculté de Medecine et des Sciences de la Santé" in Libreville, Gabonwere analyzed. Cytological status was classified according to Bethesda 2001. Nested polymerase chain reaction (PCR) using consensus degenerate PCR primers (MY09/11 and GP5+/6+) was performed for the detection of HPV DNA and HPV typing was done by DNA sequencing. RESULTS: Cytological analysis showed that 87 % of women had normal cytology (n = 174/200). Among the 26 women with cytological abnormalities, predominance (61.5 %; 16/26) of low grade squamous intraepithelial lesion (LSIL) was found and no cervical cancer case was detected. Overall, HPV DNA was detected in 60 % of women (120/200). With respect to the cytological status, HPV DNA was found in 57.5 % of women with normal cervix and 76.9 % of women with abnormal cytology. HPV genotyping was performed on 114 HPV positive cases and revealed the presence of 11 distinct genotypes: 16, 18, 33, 31, 56, 6, 66, 70, 35, 45 and 81. The high risk type HPV 16 was the most common genotype found in all cytological categories. Six HPV positive samples could not be typed by DNA sequencing, probably due to multiple HPV infection. Evaluation of possible risk factors showed that HPV infection was related positively with number of sexual partners (≥3, OR = 2.3; 95 % CI, 1.3-4.3), history of sexually transmitted infection (Chlamydia, OR = 1.9; 95 % CI, 1.01-3.4) and marital status (single, OR = 2.0; 95 % CI, 1.1-3.5). CONCLUSION: The prevalence of HPV infection among Gabonese women is high. Our findings highlight the need to set up a national program to fight cervical cancer, combining Pap smear test and HPV testing, to improve cervical cancer prevention in Gabon.
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BACKGROUND: Cervical cancer is the commonest cancer and the leading cause of cancer mortality in women in Gabon. The age-standardized incidence of cervical cancer is 19.9 per 100 000 women and the mortality rate is 8.4 per 100 000. Various international studies have identified the lack of awareness and knowledge about cervical cancer as barriers to use preventive methods. This article assesses the awareness and knowledge about cervical cancer, Pap smear testing and its use and HPV among women living in Libreville, Gabon. METHODS: This study was conducted in October 2014 in Libreville. A total of 452 women aged 16 years and above were recruited from different town locations. Logistic regression analysis was used to identify the effect of demographic characteristics on the level of knowledge about cervical cancer, Pap smear testing and HPV. Odds ratio and 95% confidence intervals were used to identify the strength of association. Associations were considered statistically significant at p < 0.05. RESULTS: Of all the women interviewed, 91.6% (414/452) had heard about cervical cancer and only 27.9% (126/452) had heard of Pap smear test. Of these 126 women, only 65.1% (82/126) had done cervical cancer screening and 68.3% (56/82) on the suggestion of a doctor. The most common reason for not undergoing Pap smear testing was neglect (50%, 22/44) followed by lack of financial resources (13.6%, 6/44), fear of discovering a serious disease (13.6%, 6/44) and deeming it unimportant (13.6%, 6/44). Only 8% (40/452) of the participants had heard about HPV and their knowledge of HPV was fair. There is a very poor level of knowledge about cervical cancer among Gabonese women. CONCLUSION: This study demonstrates a very low level of knowledge about cervical cancer, Pap smear testing and HPV in a sample of Gabonese women. There is a critical need for Gabonese women to be informed about cervical cancer and the Pap smear test to improve the use of this preventive method. The implication of health staff and Gabonese media should be included as a centerpiece in the effort to inform the population in order to reduce the burden of cervical cancer in Gabon and save women lives.
