Presencia de lesiones preinvasoras e invasoras de cérvix, relación con el virus papiloma humano y factores epidemiológicos en Mérida, Venezuela

Presence of preinvasive and invasive cervical lesions, related to human papilloma virus and epidemiological factors in Mérida, Venezuela

  • Luis Eduardo Téllez Gil Universidad de Los Andes - Venezuela
  • Elvia María Michelli Viña Universidad de Oriente - Venezuela
  • Diana Estela Callejas Monsalve Universidad del Zulia - Venezuela
  • Mike Contreras Colmenares Universidad de Los Andes - Venezuela
  • María Eugenia Cavazza Porro Instituto de Biomedicina, Ministerio del Poder Popular para la Salud - Venezuela
  • María Correnti de Plata Instituto de Oncología y Hematología, Ministerio del Poder Popular para la Salud - Venezuela

Resumen

 
Las lesiones de cérvix se han asociado a infección por Virus Papiloma Humano (VPH). 300 mujeres mayores de quince años que acudieron al Hospital Universitario de Los Andes (HULA), fueron estudiadas para identificar lesiones, detectar y tipificar VPH, y determinar factores asociados. Se realizó citología, colposcopia, cepillados cervicales utilizando (DNA collection device Digene®) y biopsias en los casos pertinentes. Se aisló el ADN mediante (QIAamp DNA Mini Kit QIAGEN®), siendo cuantificado y almacenado a -20 ºC. Se detectó VPH por Reacción en Cadena de la Polimerasa (PCR) de regiones L1 y E6/E7. La genotipificación por PCR anidada múltiple E6/E7, C. trachomatis se detectó por PCR. El VPH se detectó en 35 % (105) muestras, 88,46 % (92/105) fueron positivas para al menos uno de los genotipos evaluados. VPHAR se encontraron en 97,82 %, (90/92), VPH18 en 82 % (74/90), VPH16 en 44 % (40/90). 56,52 % (52/92) correspondieron a infecciones múltiples, VPH18/16 (20/52) fue la más frecuente. C. trachomatis se detectó en 9 % (27/300) pacientes. La citología mostró cambios sugestivos de infección en solo 16,35 % de las pacientes VPH positivas. 17/18 biopsias sugirieron infección viral y fueron positivas para VPH AR por biología molecular (94,44 %). La colposcopia sugirió infección viral en 46,15 %. El 66,34 % de pacientes fueron menores de 35 años. Se encontró relación estadísticamente no significativa entre infección por VPH, número de parejas sexuales, coinfección con C. trachomatis y hábito tabáquico. Estos resultados muestran elevada frecuencia de infección por VPH AR, asociada a factores epidemiológicos, cuyo diagnóstico certero y tratamiento oportuno son claves en la prevención de su transmisión y del desarrollo de lesiones en cérvix.
 
Palabras clave: Cáncer cervical, virus papiloma humano, reacción en cadena de la polimerasa.
 
Abstract
 
Cervical lesions have been associated with infection by Human Papilloma Virus (HPV). Three hundred women older than 15 years old who attended at the Hospital Universidad de Los Andes (HULA), were studied to identify lesions, detect and typify HPV, and determine associated factors. Cytology, colposcopy, cervical brushing using (DNA collection device Digene®) and biopsies were performed in the pertinent cases. DNA was isolated by (QIAamp DNA Mini Kit QIAGEN®), being quantified and stored at -20 ° C. HPV was detected by Polymerase Chain Reaction (PCR) of regions L1 and E6 / E7. The genotyping by multiple nested PCR E6 / E7, C. trachomatis was detected by PCR. HPV was detected in 35% (105) samples, 88.46% (92/105) were positive for at least one of the genotypes evaluated. VPHAR were found in 97.82% (90/92), HPV18 in 82% (74/90), HPV16 in 44% (40/90). 56.52% (52/92) corresponded to multiple infections, HPV18 / 16 (20/52) was the most frequent. C. trachomatis was detected in 9% (27/300) patients. The cytology showed changes suggestive of infection in only 16.35% of the HPV positive patients. 17/18 biopsies suggested viral infection and were positive for ARV HPV by molecular biology (94.44%). Colposcopy suggested viral infection in 46.15%. 66.34% of patients were under 35 years old. A statistically non-significant relationship was found between HPV infection, number of sexual partners, coinfection with C. trachomatis and smoking habit. These results show high frequency of infection by HPV AR, associated with epidemiological factors, whose accurate diagnosis and timely treatment are key in the prevention of its transmission and the development of lesions in the cervix.
 
Keywords: Cervical cancer, human papilloma virus, polymerase chain reaction.

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Publicado
2018-05-01
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