Identification of DNA sequences and viral proteins of 6 human papillomavirus types in retinoblastoma tissue.

PURPOSE: To detect DNA and proteins of human papillomavirus (HPV) in paraffin-embedded retinoblastoma (RB) tissue, to identify the viral types present and to describe a possible association between the presence of HPV and a particular form of RB. MATERIALS AND METHODS: Fifty-one samples from ocular tissues of RB patients and of six controls enucleated for non-neoplastic reasons were obtained and analyzed by Polymerase Chain Reaction (PCR) with consensus primers to detect HPV. Viral type identification was performed by Restriction Fragment Length Polymorphisms (RFLP) analysis. To corroborate the presence of HPV, immunohistochemical analysis with a polyclonal anti-HPV antibody was performed in 10 RB cases and in all controls. RESULTS: Forty-two (82.3%) of the 51 samples were HPV-positive. HPV 6 was detected in 40 cases (95.2%), HPV 33 in 16 (38.1%), HPV 11 in 4 (9.5%) and HPV 31, 35 and 51 each in one case (2.3%). All controls were negative for HPV-DNA. The positive samples were PCR-tested for HPV 16 and 18 using specific primers, and were all negative. For immunohistochemical analysis, 7 out of 10 PCR-positive samples randomly chosen were positive; all six controls were negative. CONCLUSION: No differences in the HPV type distribution were found between the groups formed according to the tumor presentation or to the mode of inheritance.

[Squamous intra-epithelial lesions in HIV seropositive females. Their frequency and association with cervical neoplasia risk factors]. / Lesiones escamosas intraepiteliaes en pacientes VIH seropositivas. Su frecuencia y asociación con factores de riesgo para neoplasia cervical.

OBJECTIVE: Determining the prevalence of squamous intraepithelial lesions (SIL), and their association with known cervical neoplasia risk factors in seropositive HIV female patients. MATERIALS AND METHODS: A transversal study including 50 seropositive HIV female patients was carried out. The patients were interrogated concerning known cervical neoplasia risk factors. Cervical cytology tests and colposcopic evaluations of the lower genital tract, with directed biopsies, were carried out. The presence of HPV-DNA was investigated using the polymerase chain reaction and CD4 and CD8 T lymphocyte titers were determined. Two comparison groups were formed, in accordance to the presence or absence of cervical lesions. RESULTS: Average age was 36 +/- 9.3 years, ranging from 20 to 61 years, 26% had never submitted to a cervical cytology test, and an average of 33 months (1-130 months) had elapsed after the last test of those who had. HIV transmission had been sexual in 72% of the cases, and the period of time elapsed since the infection was diagnosed and until the patients were evaluated for this study was of 40.6 +/- 33.5 months. HPV-DNA was detected in 64% (n = 32) of the patients, and co-infection with more than one HPV was detected in 42% of them, with the 16 and 31 types being the most frequent. A cervical lesion was diagnosed in 52% of the cases, 18% being of high degree and 34% of low degree. When risk factors for cervical neoplasia and lymphocyte titers were compared between group I (with SIL, n = 26), and group II (without SIL, n = 24), the only significant differences found were the presence of HPV-DNA and the co-infection with more than one type of HPV, which were more frequent in group I. Sexual transmission of HIV was also more frequent in group I. The presence of vaginal and vulvar synchronous lesions was determined in 20% and 12% of the cases, respectively. CONCLUSIONS: There is a high prevalence of positive DNA-HPV and SIL in seropositive HIV patients, which pose them in a higher risk of developing invasive cervical cancer. Thus, creating adequate strategies for the detection, diagnosis, management, and follow-up of these patients is of the utmost importance.

Polimorfismo en el codón 72 del gen p53 y riesgo de cáncer cérvico-uterino en México / Polymorphism in codon 72 of the p53 gene and cervico-uterine cancer risk in Mexico

A polymorphism at codon 72 in the p53 gen has been reported as a potential risk factor to cervical cancer (CC) because human papillomavirus (HPV) is more effective at degrading p53 Arg-72 than p53 Pro-72, making individuals homozygous for p53 Arg-72 seven times more likely to develop HPV-associated CC. As In Mexico the CC is a health public problem, we designed this study to determinate whether the p53 codon 72 polymorphism represent a risk factor to CC in our population. A case-controls study was performed. DNA was obtained from paraffin-embedded cervical fixed tissue samples. Analysis of the p53 genotype at position 72 was performed by polymerase chain reaction using specific primers and Accll digestion. Among cases with CC the proportions of the p53 genotypes at codon 72 were 0.05 to proline homozygous, 0.5 to heterozygous, and 0.45 to arginine-homozygous. In controls the proportions were 0.08, 0.62, and 0.31. X2 test showed no significant difference In the proportions. We conclude than In our population, as other worldwide countries, the homozygous for arginine at codon 72 of the p53 gene is not a risk factor to cervical cancer.

Validación diagnóstica de la aspiración manual endouterina para la detección de hiperplasia y cáncer de endometrio en pacientes con sangrado uterino anormal / Diagnostic validity of endouterine manual aspiration for detection of hiperplasia and cancer of endometrium in patients with abnormal uterine bleeding

Determinar el valor diagnóstico de la aspiración manual endouterina con cánula de Karman (AMEU) para la detección de hiperplasia/cáncer de endometrio en pacientes con sangrado uterino anormal. Se incluyeron 50 pacientes con sangrado uterino anormal a las que se realizó biopsia endometrial por AMEU e inmediatamente después legrado uterino instrumental (LUI. Se registró la necesidad de dilatación cervical para la toma de los especímenes. Se llevó a cabo un análisis pareado de los reportes histológicos por medio de la prueba de contraste de Wilcoxon. Para la validación diagnóstica de la biopsia endometrial por AMEU se consideró como el estándar de referencia a la histología del espécimen obtenido por LUI. Se calculó sensibilidad, especificidad, probabilidad pre prueba (prevalencia), probabilidades post-prueba (valores predictivos) y razones de verosimilitud. No se encontró diferencia estadísticamente significativa en el análisis pareado de los reportes histológicos. Fue significativamente más frecuente la necesidad de dilatación cervical para la toma del espécimen endometrial por LUI (p = 0.0002) sin encontrar diferencia en la proporción de muestras insuficientes entre ambas técnicas. La prevalencia (probabilidad pre prueba) de hiperplasia/cáncer fue de 20 por ciento Hubo dos casos de hiperplasia no detectados por AMEU (falsos negativos 20 por ciento) La AMEU mostró una sensibilidad de 71 por ciento y especificidad de 93 por ciento. La probabilidad post prueba para una biopsia endometrial anormal y normal (valor predictivo positivo y negativo) fueron 62 5 y 95 2 por ciento, respectivamente, con una razón de verosimilitud positiva de 10 23 y negativa de 0 3. La biopsia endometrial por AMEU tiene un valor diagnóstico elevado. similar al LUI en la detección de hiperplasia/cáncer de endometrio en pacientes con sangrado uterino anormal, con la ventaja de ser un procedimiento de consultorio sin los riesgos y costos del LUI.