Cell-mediated immunity (CMI) response to different antigens was examined in healthy women, in patients with cervical precancerous lesions, and in patients with cervical cancer. Cervical lesions were diagnosed by cytological (PAP) smears, from examination by colposcopy, and from "punch" biopsy material by histology. CMI response is related to specific processes in healthy and cancer cells. CMI was investigated by leukocyte adherence inhibition (LAI) assay using specific antigen (prepared from cervical carcinoma tissue) and non specific antigen (prepared from blood of mice infected by LDH--lactate dehydrogenase--virus). The CMI responses of healthy women and cancer patients to the antigens used are different: the majority of T lymphocytes display adherence and non adherence, respectively (but the CMI responses elicited by the antigens are not equal and small quantitative differences are observed). Regardless of the CIN (cervical intraepithelial neoplasia) grades, CMI responses correspond either to healthy women or to cervical carcinoma patients (at about similar ratio of cases in all the CIN groups). Effect of non specific antigen suggests that cervical carcinoma transformation may be connected with reduction of mitochondrial activity similar to processes in LDH virus infection.
- MeSH
- antigeny nádorové metabolismus MeSH
- buněčná adheze MeSH
- buněčná imunita MeSH
- L-laktátdehydrogenasa metabolismus MeSH
- LDH virus metabolismus MeSH
- leukocyty cytologie MeSH
- lidé MeSH
- mitochondrie metabolismus MeSH
- nádory děložního čípku genetika imunologie patologie MeSH
- prekancerózy MeSH
- T-lymfocyty patologie virologie MeSH
- vysokoúčinná kapalinová chromatografie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
Cíl studie: Zhodnocení regrese, progrese histologicky ověřených lehkých stupňů skvamózních intraepiteliálních lézí (LG SIL) u žen do 35 let věku v závislosti na pozitivitě onkogenních typů humánních papilomavirů (HPV HR). Posouzení senzitivity cytologie a HPV HR testace u žen s LG SIL. Typ studie: Prospektivní studie. Název a sidlo pracoviště: Gynekologicko-porodnická klinika, Univerzita Karlova, Praha, 2. LF a Fakultní nemocnice Motol, Praha. Soubor a metodika: Do studie bylo zařazeno 166 žen s cytologickým nálezem SIL low nebo opakovaným nálezem ASC-US. Pod kontrolou expertní kolposkopie byly provedeny u všech žen 1 až 3 punch biopise a HPV HR testace. Ženy s histologicky ověřenou LG SIL byly dispenzarizovány v intervalu 6 měsíců. Výsledky: Punch biopsie prokázala ve 120 případech LG SIL. Senzitivita cytologie pro LG SIL byla 72,3 % a senzitivita HPV HR testace byla 60,2 %. Celkem 84 žen (70 %) bylo HPV HR pozitivních. Ve 20 případech (23 %) s LG SIL a pozitivitou HPV HR došlo k regresi, u HPV HR negativních žen bylo 18 (50 %) regresí. Rozdíl je statisticky významný (p = 0,0094). Progrese nálezu byla ve skupině HPV HR pozitivních zaznamenána ve 24 případech (tj. v 29 %), u HPV HR negativních došlo k progresi pouze ve 4 případech (11 %). Tento rozdíl je na hranici statistické významnosti (p = 0,058). Během dispenzarizace nedošlo u žádné ženy k progresi do carcinoma in situ nebo invazivního karcinomu. Závěr: Onkologická cytologie je standardem pro vyhledávání LG SIL u žen do 35 let a přínos HPV HR testace pro detekci LG SIL je v této věkové kohortě malý. Přínos HPV HR testace pro stanovení rizika progrese či regrese je větší, ale pozitivita HPV HR testace u LG SIL by v této věkové skupině neměla vést k rozhodnutí o provedení konizace.
Objective: Evaluation of regression and progression of histologically confirmed low grade squamous intraepithelial lesions (LG SIL) in women under the age of 35 in context of positivity of high risk human papillomavirus (HPV HR). Evaluation of sensitivity of PAP smear and HPV HR test in women with LG SIL. Design: Prospective study. Setting: Department of Obstetrics and Gynecology, Charles University Prague, 2nd Medical Faculty, University Hospital Motol. Patients and methods: 166 women with SIL low or repeated ASC-US PAP smear were included to the study. 1 to 3 punch biopsy under the expert colposcopy and HPV HR test were performed in all women. Follow up were done every 6 month in all women with histologically confirmed LG SIL. Results: LG SIL was detected in 120 women. Sensitivity of PAP smear was 72.3 % and sensitivity of HPV HR test 60.2 % in women with LG SIL. 84 women (70 %) were HPV HR positive. Regression of LG SIL was detected in 20 (23 %) HPV HR positive women and in 18 (50 %) HPV HR negative women. This difference is statistically significant (p = 0,0094). Progression of LG SIL was detected in 24 (29 %) HPV HR positive women and in 4 (11 %) women HPV HR negative women. This difference is borderline statistically significant (p = 0.058). Progression of LG SIL to the carcinoma in situ or invasive cancer had not been detected during follow up period. Conclusion: PAP smear is a standard for LG SIL detection in women under the age of 35 and HPV HR test is not so important for LG SIL detection in this group of women. HPV HR test could be useful for prediction of the risk of progression, but positivity of HPV HR in LG SIL cannot indicate surgical treatment (conisation) in this cohort of women under the age of 35.
The principal aims of this study were to test whether persistence of human papillomavirus (HPV) DNA is predictive of recurrent disease in women after surgical treatment for cervical lesions, to distinguish between persistent and newly acquired HPV infection, and to observe the effect of surgical treatment on levels of HPV-specific antibodies. A group of 198 patients surgically treated for low-grade and high-grade squamous intraepithelial lesions and 35 age-matched controls were monitored for 18 months at 6-month intervals. The presence of HPV DNA in cervical smears was detected by means of consensus polymerase chain reaction, and serum levels of HPV-specific antibodies to HPV types 16, 18, 31, 33, and 45 were measured. In ten patients positive for HPV type 16 in consecutive samples, the HPV 16 variants were identified using a polymerase chain reaction specific for the long control region. Data regarding demographics, risk factors for cervical cancer, and risks related to HPV exposure were collected through a patient questionnaire. Subjects persistently positive for HPV DNA were more likely to present with cytological and/or colposcopical abnormalities. A higher reactivity to HPV-specific antibodies was observed in these women at the 18-month follow-up visit. All ten patients with HPV 16 infection detected in consecutive samples showed persistence of either the same prototype or the same variant during the follow-up period. Risky sexual behavior and smoking were more common in patients than in controls. Persistent HPV infection as demonstrated by both HPV DNA detection and antibody detection appears to be a risk factor for the recurrence of pathological findings in women after surgery. An individually based approach to surgical treatment is an important factor in the outcome of disease at follow-up.
- MeSH
- DNA virů analýza MeSH
- dospělí MeSH
- financování organizované MeSH
- infekce onkogenními viry MeSH
- infekce papilomavirem epidemiologie imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lidský papilomavirus 16 genetika imunologie izolace a purifikace MeSH
- longitudinální studie MeSH
- mladiství MeSH
- nádory děložního čípku chirurgie virologie MeSH
- následné studie MeSH
- nemoci cervix uteri chirurgie virologie MeSH
- Papillomaviridae genetika izolace a purifikace MeSH
- prevalence MeSH
- protilátky virové MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- senioři MeSH
- ženské pohlaví MeSH
