Advisor(s)
Abstract(s)
Introdução: O cancro do cólo do útero é o terceiro cancro mais comum no sexo feminino em todo o mundo. A infeção persistente por HPV de alto risco é considerado o agente etiológico necessário, mas não suficiente, para o seu desenvolvimento. Vários estudos sugerem a interação de outros agentes patogénicos, como o vírus de Epstein-Barr (EBV) e o Citomegalovírus (CMV).
Objectivos: O objectivo deste estudo consistiu em caracterizar a prevalência/frequência de infeção por EBV e CMV em amostras cervico-vaginais e tentar estabelecer uma correlação entre estes vírus e o desenvolvimento de cancro do cólo do útero.
Material e Métodos: Este estudo foi realizado em 89 amostras cervico-vaginais de mulheres com diferentes lesões, recolhidas no Serviço de Ginecologia do Instituto Português de Oncologia do Porto. A frequência das infecções por CMV e EBV foi avaliada por PCR em tempo real com sondas específicas para genes virais.
Resultados: O nosso estudo revelou uma frequência de 10.1% para a infeção por EBV e de 5.20% para o CMV. O DNA de CMV foi detetado em: normais (1.20%), lesão de baixo grau (8.20%), lesão de alto grau (6.80%), carcinoma in situ/carcinoma cervical invasor (13.3%); a infeção por EBV foi detetada em todos os tipos de lesões: normais (16.7%), com inflamação (5.26%), lesão de baixo grau (9.52%), lesão de alto grau (4.50%) e com carcinoma in situ/carcinoma cervical invasor (22.2%). Tanto na infeção por CMV como EBV a infeção encontrava-se em todas as faixas etárias, sem predominância em nenhuma destas. Na análise de risco, apenas a infeção por CMV revelou um aumento do risco para o desenvolvimento de carcinoma lesões de baixo grau (OR=7.73, =0.043) e todo o tipo de lesões e in situ/carcinoma invasor (OR=7.73, p=0.021). Na correlação entre a infeção por CMV/ EBV e HPV não se obtiveram resultados estatisticamente significativos que indiciassem um aumento do risco no desenvolvimento de lesões.
Conclusão: O estudo realizado demonstrou uma prevalência baixa para ambos os vírus em estudo (EBV e CMV) relativamente a estudos realizados anteriormente. Os resultados revelaram: 1) distribuição ubíqua de CMV e EBV em mulheres com diferentes lesões; e 2) A infeção por CMV deve representar um risco aumentado no desenvolvimento de carcinoma in situ/carcinoma cervical invasor.
Introduction: Cervical cancer is the third most common cancer in women worldwide. A persistent infection by high-risk HPV is considered the etiological agent necessary but not sufficient for its development. Several studies suggest an interaction of other pathogens, such as Epstein-Barr virus (EBV) and Cytomegalovirus (CMV). Aims of the study: The aim of this study was to establish a correlation between EBV and CMV infection in the development of cervical cancer by studying its prevalence in different lesions. Materials and Methods: This study was performed in 89 cervico-vaginal samples of women with different cervical lesions, who attended the Department of Gynecology at the Portuguese Institute of Oncology of Porto. The frequency of EBV and CMV infections was evaluated by real time PCR with specific probes for the viral genes. Results: Our study revealed a frequency of 10.1% women with EBV infection and 5.20% with CMV infection. The CMV DNA was detected on: normal (1.20%), low-grade lesion (8.20%), high-grade lesion (6.80%), in situ/invasive cervical carcinoma (13.3%); EBV infection was detected in all types of lesions: normal (16.7%), with inflammation (5.26%), low-grade lesion (9.52%), high-grade lesion (4.50%) and in situ/invasive cervical carcinoma (22.2%). Both CMV and EBV infection were present in all age groups, with no predominance in any of these. In risk analysis, only CMV infection revealed an increased risk for the development of low-grade lesions (OR=7.73, p=0.043) and all kinds of lesions plus in situ/invasive carcinoma (OR=7.73, p= 0.021). In the correlation between CMV/EBV and HPV infection no statistically significant results were obtained that would indicate an increased risk in the development of lesions. Conclusion: This study demonstrated a low prevalence for both viruses under study (EBV and CMV) relative to previous studies. The results showed: 1) ubiquitous distribution of CMV and EBV in women with different lesions; and 2) CMV infection should indicate an increased risk in the development of carcinoma in situ/invasive cervical carcinoma.
Introduction: Cervical cancer is the third most common cancer in women worldwide. A persistent infection by high-risk HPV is considered the etiological agent necessary but not sufficient for its development. Several studies suggest an interaction of other pathogens, such as Epstein-Barr virus (EBV) and Cytomegalovirus (CMV). Aims of the study: The aim of this study was to establish a correlation between EBV and CMV infection in the development of cervical cancer by studying its prevalence in different lesions. Materials and Methods: This study was performed in 89 cervico-vaginal samples of women with different cervical lesions, who attended the Department of Gynecology at the Portuguese Institute of Oncology of Porto. The frequency of EBV and CMV infections was evaluated by real time PCR with specific probes for the viral genes. Results: Our study revealed a frequency of 10.1% women with EBV infection and 5.20% with CMV infection. The CMV DNA was detected on: normal (1.20%), low-grade lesion (8.20%), high-grade lesion (6.80%), in situ/invasive cervical carcinoma (13.3%); EBV infection was detected in all types of lesions: normal (16.7%), with inflammation (5.26%), low-grade lesion (9.52%), high-grade lesion (4.50%) and in situ/invasive cervical carcinoma (22.2%). Both CMV and EBV infection were present in all age groups, with no predominance in any of these. In risk analysis, only CMV infection revealed an increased risk for the development of low-grade lesions (OR=7.73, p=0.043) and all kinds of lesions plus in situ/invasive carcinoma (OR=7.73, p= 0.021). In the correlation between CMV/EBV and HPV infection no statistically significant results were obtained that would indicate an increased risk in the development of lesions. Conclusion: This study demonstrated a low prevalence for both viruses under study (EBV and CMV) relative to previous studies. The results showed: 1) ubiquitous distribution of CMV and EBV in women with different lesions; and 2) CMV infection should indicate an increased risk in the development of carcinoma in situ/invasive cervical carcinoma.